Healthcare Provider Details

I. General information

NPI: 1427622059
Provider Name (Legal Business Name): WINNESHIEK MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 06/29/2023
Certification Date: 06/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 N ELM ST
CRESCO IA
52136-1519
US

IV. Provider business mailing address

901 MONTGOMERY ST
DECORAH IA
52101-2325
US

V. Phone/Fax

Practice location:
  • Phone: 563-382-2911
  • Fax:
Mailing address:
  • Phone: 563-382-2911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: STEVEN ROBERT SLESSOR
Title or Position: CAO
Credential:
Phone: 563-387-3145