Organization
NOVA INTEGRATED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL BRUNSTAD PA (OWNER/PHYSICIAN ASSISTANT)
(715) 891-0088
Entity
Organization
Contact information
Practice address
302 W PINE ST STE 2, EAGLE RIVER, WI 54521-9349
(715) 891-0088
Mailing address
302 W PINE ST STE 2, EAGLE RIVER, WI 54521-9349
(715) 891-0088
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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