Healthcare Provider Details

I. General information

NPI: 1316092976
Provider Name (Legal Business Name): UNIVERSITY OF WISCONSIN SYSTEM NON PAYROLL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S THIRD ST B31 WEB UW RIVER FALLS SPEECH AND HEARING CLINIC
RIVER FALLS WI
54022
US

IV. Provider business mailing address

410 S THIRD ST B31 WEB UW RIVER FALLS SPEECH AND HEARING CLINIC
RIVER FALLS WI
54022
US

V. Phone/Fax

Practice location:
  • Phone: 715-425-3801
  • Fax: 715-425-3800
Mailing address:
  • Phone: 715-425-3801
  • Fax: 715-425-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOEL HEUSCHELE
Title or Position: CONTROLLER
Credential: CPA
Phone: 715-425-3265