Organization
GREAT RIVER COMMUNITY MEDICAL CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A GRUNWALD MD (PRESIDENT)
(608) 326-5459
Entity
Organization
Contact information
Practice address
100 N MARQUETTE RD, SUITE 106, PRAIRIE DU CHIEN, WI 53821
(608) 326-1072
(608) 326-1076
Mailing address
100 N MARQUETTE RD, SUITE 106, PRAIRIE DU CHIEN, WI 53821
(608) 326-1072
(608) 326-1076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
23379
WI
207Q00000X
Family Medicine Physician
Primary
23439
WI
Other
Enumeration date
05/30/2008
Last updated
10/06/2008
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