| Cleveland Va Cboc | |
|
1205 North Ave Cleveland WI 53015-1413 | |
| (188) 469-6614 | |
| Not Available |
| Full Name | Cleveland Va Cboc |
|---|---|
| Speciality | Clinic/center |
| Location | 1205 North Ave, Cleveland, Wisconsin |
| Authorized Official Name and Position | Agnes E. Deehr (LPN) |
| Authorized Official Contact | 9206935600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cleveland Va Cboc 336 E Jefferson Ave Cleveland WI 53015-1530 Ph: (920) 693-8478 | Cleveland Va Cboc 1205 North Ave Cleveland WI 53015-1413 Ph: (188) 469-6614 |
| NPI Number | 1154337558 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154337558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 8882-031 (Wisconsin) | Primary |