Healthcare Provider Details

I. General information

NPI: 1003089087
Provider Name (Legal Business Name): NORTH CRAWFORD SCHOOL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47050 COUNTY ROAD X
SOLDIERS GROVE WI
54655-8551
US

IV. Provider business mailing address

47050 COUNTY ROAD X
SOLDIERS GROVE WI
54655-8551
US

V. Phone/Fax

Practice location:
  • Phone: 608-735-4318
  • Fax: 608-735-4317
Mailing address:
  • Phone: 608-735-4318
  • Fax: 608-735-4317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. DANIEL MICHAEL DAVIES
Title or Position: DISTRICT ADMINISTRATOT
Credential: ED.D.
Phone: 608-735-4318