Organization
SNF CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN J HETTRICK MD (PHYSICIAN)
(262) 843-2394
Entity
Organization
Contact information
Practice address
7137 236TH AVE STE 103, SALEM, WI 53168-8975
(262) 843-4422
(262) 843-1166
Mailing address
7137 236TH AVE STE 103, SALEM, WI 53168-8975
(262) 843-4422
(262) 843-1166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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