| Family Health/la Clinica | |
|
400 S Townline Rd Wautoma WI 54982-1440 | |
| (920) 787-5514 | |
| (920) 787-4737 |
| Full Name | Family Health/la Clinica |
|---|---|
| Speciality | Family Medicine |
| Location | 400 S Townline Rd, Wautoma, Wisconsin |
| Authorized Official Name and Position | Laura Waldvogel (PRESIDENT/CEO) |
| Authorized Official Contact | 9207875514 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Health/la Clinica Po Box 1440 400 S Townline Rd Wautoma WI 54982-1440 Ph: (920) 787-5514 | Family Health/la Clinica 400 S Townline Rd Wautoma WI 54982-1440 Ph: (920) 787-5514 |
| NPI Number | 1124276324 |
|---|---|
| Provider Enumeration Date | 09/03/2008 |
| Last Update Date | 02/06/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124276324 | NPI | - | NPPES |
| 70030 | Other | WI | MEDICARE |
| 32955200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (Wisconsin) | Primary |
Waushara Dental Associates S.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: N2888 State Road 22, Wautoma, WI 54982 Phone: 920-787-3200 Fax: 920-787-2541 |