Organization
BRIAN VAN HOOZEN DO SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN L VAN HOOZEN D.O. (OWNER)
(920) 982-7900
Entity
Organization
Contact information
Practice address
1505 MILL ST, NEW LONDON, WI 54961-2187
(920) 982-7900
(920) 982-7995
Mailing address
PO BOX 96, NEW LONDON, WI 54961-0096
(920) 982-7900
(920) 982-7995
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
32699
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30054700
—
WI
01
—
32699
LICENSE NUMBER
WI
Enumeration date
03/25/2008
Last updated
03/07/2023
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