Healthcare Provider Details

I. General information

NPI: 1275368193
Provider Name (Legal Business Name): REFORMEDICINE, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2024
Last Update Date: 09/03/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W. ELM
CHIPPEWA FALLS WI
54729
US

IV. Provider business mailing address

3004 GOLF ROAD SUITE 100
EAU CLAIRE WI
54701
US

V. Phone/Fax

Practice location:
  • Phone: 715-738-2700
  • Fax: 877-224-8121
Mailing address:
  • Phone: 715-514-2827
  • Fax: 888-606-1323

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: DR. DAVID JOHN USHER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 715-514-2827