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Organization

ROCK RIVER COMMUNITY CLINIC, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS ABE MARTINEZ (MANAGER)
(920) 563-4372
Entity
Organization

Contact information

Practice address
520 HANDEYSIDE, SUITE 4, FORT ATKINSON, WI 53538
(920) 563-4372
(920) 463-4374
Mailing address
520 HANDEYSIDE LN STE 4, FORT ATKINSON, WI 53538-1279
(920) 563-4372
(920) 463-4374

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38397100
WI
Enumeration date
01/18/2008
Last updated
05/27/2025
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