Organization
PAIN CLINIC OF NORTHWESTERN WISCONSIN SC
Active
Organization
PAIN CLINIC OF NORTHWESTERN WISCONSIN SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN MATHIAS ENDRES (AUTHORIZED REPRESENTATIVE)
(715) 552-5346
Entity
Organization
Contact information
Practice address
1221 WHIPPLE ST, EAU CLAIRE, WI 54703-5270
(715) 552-5346
(715) 838-6596
Mailing address
PO BOX 1185, EAU CLAIRE, WI 54702-1185
(715) 552-5346
(715) 838-6596
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32805000
—
WI
Enumeration date
03/10/2006
Last updated
11/21/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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