Organization
GRANT REGIONAL FAMILY PRACTICE
Active
Parent organization
GRANT REGIONAL HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANT REGIONAL HEALTH CENTER
Authorized official
NICOLE CLAPP (CEO)
(608) 723-3200
Entity
Organization
Contact information
Practice address
507 S MONROE ST, LANCASTER, WI 53813-2054
(608) 723-3293
(608) 723-3281
Mailing address
507 S MONROE ST, LANCASTER, WI 53813-2054
(608) 723-3293
(608) 723-3281
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32765000
—
WI
Enumeration date
05/11/2006
Last updated
10/22/2007
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