Organization
ST CLARE IMAGING SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TROY WALKER (DIRECTOR OF FINANCE)
(608) 356-1423
Entity
Organization
Contact information
Practice address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Mailing address
707 14TH ST, BARABOO, WI 53913-1539
(608) 356-1400
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043767
PHYS PLUS PROV #
WI
05
—
21278400
—
WI
01
—
567258
DEANCARE PROV #
WI
Enumeration date
11/22/2005
Last updated
11/27/2023
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