Individual
FREDERICK W ROCHACEWICZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2817 NEW PINERY RD, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901-9257
(608) 745-4598
(608) 745-6242
Mailing address
PO BOX 387, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901-0387
(608) 745-4598
(608) 745-6242
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
678023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42952000
—
WI
Enumeration date
11/23/2005
Last updated
07/08/2007
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