Healthcare Provider Details

I. General information

NPI: 1790777621
Provider Name (Legal Business Name): KROHN CLINIC LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 W ADAMS ST
BLACK RIVER FALLS WI
54615-9010
US

IV. Provider business mailing address

610 W ADAMS ST
BLACK RIVER FALLS WI
54615-9010
US

V. Phone/Fax

Practice location:
  • Phone: 715-284-4311
  • Fax: 715-284-0475
Mailing address:
  • Phone: 715-284-4311
  • Fax: 715-284-2568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SANDRA K SALSMAN
Title or Position: DIRECTOR OF FINANCE
Credential:
Phone: 715-284-4311