Healthcare Provider Details

I. General information

NPI: 1578129995
Provider Name (Legal Business Name): CALE ARMSTRONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2019
Last Update Date: 05/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

S13009 SHIFFLET RD
SPRING GREEN WI
53588-9696
US

IV. Provider business mailing address

S13009 SHIFFLET RD
SPRING GREEN WI
53588-9696
US

V. Phone/Fax

Practice location:
  • Phone: 608-553-0965
  • Fax:
Mailing address:
  • Phone: 608-553-0965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License NumberDC-041900223
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: