Healthcare Provider Details

I. General information

NPI: 1790912004
Provider Name (Legal Business Name): TOP HAT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 06/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 HOOD ST
LA CROSSE WI
54601-5238
US

IV. Provider business mailing address

226 HOOD ST
LA CROSSE WI
54601
US

V. Phone/Fax

Practice location:
  • Phone: 608-782-1069
  • Fax: 608-784-7233
Mailing address:
  • Phone: 608-782-1069
  • Fax: 608-784-7233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number68379
License Number StateWI

VIII. Authorized Official

Name: HEATHER CLINE
Title or Position: TRANSPORTATION MANAGER
Credential:
Phone: 608-782-1069