| Diagnostic & Treatment Center, Llc | |
|
3401 Cranberry Blvd Weston WI 54476 | |
| (715) 393-2489 | |
| (715) 241-9475 |
| Full Name | Diagnostic & Treatment Center, Llc |
|---|---|
| Speciality | Clinic/center - Radiology |
| Location | 3401 Cranberry Blvd, Weston, Wisconsin |
| Authorized Official Name and Position | Colleen Chisnell (SENIOR DIRECTOR OF FINANCE) |
| Authorized Official Contact | 7153932499 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diagnostic & Treatment Center, Llc 3401 Cranberry Blvd Weston WI 54476 Ph: (715) 393-2489 | Diagnostic & Treatment Center, Llc 3401 Cranberry Blvd Weston WI 54476 Ph: (715) 393-2489 |
| NPI Number | 1215953823 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 05/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215953823 | NPI | - | NPPES |
| 21290300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 54844 (Wisconsin) | Secondary |
| 261QR0200X | Clinic/center - Radiology | 400055 (Wisconsin) | Primary |
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