Organization · Type 2 NPI
Random Lake Spine & Sports Clinic
Clinic/Center · Random Lake, WI
NPI number
1659543205
Active
Practice location
321 Carroll St.
Random Lake, WI 53075
Mailing address
PO Box 196
Random Lake, WI 53075-0196
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | None listed |
Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Other clinic/center providers in Random Lake
About NPI 1659543205
Random Lake Spine & Sports Clinic's National Provider Identifier is 1659543205, issued on Mar 24, 2008. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Random Lake, WI. The record was last updated on Jun 2, 2008.