| Badger Iom, Llc | |
|
4321 W College Ave Suite 200 Appleton WI 54914 | |
| (210) 598-4277 | |
| Not Available |
| Full Name | Badger Iom, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Clinical Neurophysiology |
| Location | 4321 W College Ave, Appleton, Wisconsin |
| Authorized Official Name and Position | Roxanna Laroque (DIRECTOR OF CLIENT EXPERIENCE) |
| Authorized Official Contact | 2105984277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Badger Iom, Llc 1141 N Loop 1604 E #105-612 San Antonio TX 78232-0046 Ph: (210) 598-4277 | Badger Iom, Llc 4321 W College Ave Suite 200 Appleton WI 54914 Ph: (210) 598-4277 |
| NPI Number | 1730680539 |
|---|---|
| Provider Enumeration Date | 02/27/2018 |
| Last Update Date | 08/12/2022 |
| Certification Date | 08/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730680539 | NPI | - | NPPES |
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