Organization
PODIATRY ASSOCIATES OF WAUSAU, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL E JOURDAN DPM (PRESIDENT)
(715) 675-2321
Entity
Organization
Contact information
Practice address
1630 CHIPPEWA DR, RHINELANDER, WI 54501-9503
(715) 362-6813
(715) 362-6813
Mailing address
1445 MERRILL AVE, WAUSAU, WI 54401-2646
(715) 675-2321
(715) 675-6530
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DME SUPPLIER #
0427710002
—
Enumeration date
03/10/2006
Last updated
06/29/2010
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