Individual
MR. AUSTIN R REBEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
109777
IA
363AM0700X
Medical Physician Assistant
13797
MN
363AM0700X
Medical Physician Assistant
Primary
5540
WI
Other
Enumeration date
03/31/2020
Last updated
11/24/2021
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