Organization
CHP-LTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN A BULLOCK (CEO)
(715) 838-2901
Entity
Organization
Contact information
Practice address
2240 EASTRIDGE CTR, EAU CLAIRE, WI 54701-3410
(715) 838-2900
(715) 858-7023
Mailing address
2240 EASTRIDGE CTR, EAU CLAIRE, WI 54701-3410
(715) 838-2900
(715) 858-7023
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69008200
—
WI
Enumeration date
07/17/2008
Last updated
07/17/2008
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