Organization
GUNDERSEN CLINIC, LTD.
Active
Parent organization
GUNDERSEN CLINIC, LTD.
Other names
GL Independence Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
GUNDERSEN CLINIC, LTD.
Authorized official
KARI B ADANK (CCO)
(608) 775-8025
Entity
Organization
Contact information
Practice address
35791 OSSEO RD, INDEPENDENCE, WI 54747-9096
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43062500
—
WI
Enumeration date
05/17/2006
Last updated
03/07/2016
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