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Organization

KLASINSKI CLINIC, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CHASE L BEHRENDT MBA (ADMINISTRATOR)
(715) 344-2164
Entity
Organization

Contact information

Practice address
500 VINCENT ST, STEVENS POINT, WI 54481-1848
(715) 344-0701
(715) 344-4494
Mailing address
500 VINCENT ST, STEVENS POINT, WI 54481-1848
(715) 344-0701
(715) 344-4494

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
0917050001
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30670500
WI
05
31827000
WI
05
32144600
WI
05
32166500
WI
05
42969800
WI
05
42986500
WI
01
CP7737
PALMETTO GBA-RR MEDICARE
WI
Enumeration date
06/02/2006
Last updated
02/19/2014
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