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Organization

FOREST COUNTY POTAWATOMI HEALTH & WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. NED DANIELS (TRIBAL CHAIRMAN)
(715) 478-4824
Entity
Organization

Contact information

Practice address
8201 MISHKOSWEN DR, CRANDON, WI 54520-0396
(715) 478-4300
(715) 478-4490
Mailing address
PO BOX 396, CRANDON, WI 54520-0396
(715) 478-4300
(715) 478-4490

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
41752300
WI
Enumeration date
02/23/2009
Last updated
12/10/2020
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