Healthcare Provider Details

I. General information

NPI: 1447439997
Provider Name (Legal Business Name): COLEMAN SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 BUSINESS 141 N
COLEMAN WI
54112-9453
US

IV. Provider business mailing address

343 BUSINESS 141 N
COLEMAN WI
54112-9453
US

V. Phone/Fax

Practice location:
  • Phone: 920-897-4011
  • Fax:
Mailing address:
  • Phone: 920-897-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateWY

VIII. Authorized Official

Name: DR. ROBERT WERLEY
Title or Position: DISTRICT ADMINISTRATOR
Credential:
Phone: 920-897-4011