Healthcare Provider Details

I. General information

NPI: 1063663599
Provider Name (Legal Business Name): BEST FRIENDS VETERINARY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 10/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2082 CHEYENNE AVE
GRAFTON WI
53024-9368
US

IV. Provider business mailing address

2082 CHEYENNE AVE
GRAFTON WI
53024-9368
US

V. Phone/Fax

Practice location:
  • Phone: 262-375-0130
  • Fax:
Mailing address:
  • Phone: 262-375-0130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number2750-050
License Number StateWI

VIII. Authorized Official

Name: DR. NAN L BOSS
Title or Position: PRACTICE OWNER
Credential: DVM
Phone: 262-375-0130