Healthcare Provider Details

I. General information

NPI: 1063769578
Provider Name (Legal Business Name): MATTHEW MORGAN SPRINGER CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2012
Last Update Date: 12/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BELLINGER ST
EAU CLAIRE WI
54703-5222
US

IV. Provider business mailing address

3121 OAK KNOLL DR APT #4
EAU CLAIRE WI
54701-6400
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-7000
  • Fax:
Mailing address:
  • Phone: 785-342-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: