Organization
CLARK COUNTY HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE SCHIMDT (ADMINISTRATOR)
(715) 229-2172
Entity
Organization
Contact information
Practice address
W4266 STATE ROAD 29, OWEN, WI 54460-8932
(715) 229-2172
Mailing address
N13874 COUNTY ROAD O, WITHEE, WI 54498-9045
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
29-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29-027
O.T. LIC.
WI
05
—
40608400
—
WI
Enumeration date
05/18/2007
Last updated
09/19/2007
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