Individual
CLARISSA J RENKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2720 PLAZA DR, SUITE 1300, WAUSAU, WI 54401-4158
(715) 847-2630
Mailing address
2720 PLAZA DR, SUITE 1300, WAUSAU, WI 54401-4158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
54752-21
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
04/28/2009
Last updated
06/20/2012
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