Organization
GRUBE ANESTHESIA SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS M GRUBE CRNA (OWNER)
(715) 652-3219
Entity
Organization
Contact information
Practice address
2108 KOHLER MEMORIAL DR, STE 101, SHEBOYGAN, WI 53081-3100
(920) 451-8142
Mailing address
4293 BECKER RD, AUBURNDALE, WI 54412-9530
(715) 652-3219
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
35223
WI
Other
Enumeration date
10/01/2012
Last updated
10/11/2012
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