Individual
SAMUEL CENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2222 E 5TH ST, SUPERIOR, WI 54880-3709
(715) 392-1955
(715) 392-1935
Mailing address
2222 E 5TH ST, SUPERIOR, WI 54880-3709
(715) 395-5393
(715) 392-1935
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1101970-30
WI
163W00000X
Registered Nurse
2390967
MN
Other
Enumeration date
08/19/2022
Last updated
01/30/2024
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