Healthcare Provider Details

I. General information

NPI: 1891121687
Provider Name (Legal Business Name): FIRST ASSIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PINTAIL LN
WAUSAU WI
54401-8110
US

IV. Provider business mailing address

1200 PINTAIL LN
WAUSAU WI
54401-8110
US

V. Phone/Fax

Practice location:
  • Phone: 715-581-9861
  • Fax: 715-848-9015
Mailing address:
  • Phone: 715-581-9861
  • Fax: 715-848-9015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number238.000371
License Number StateIL

VIII. Authorized Official

Name: ALLEN LIMBERG
Title or Position: MEMBER
Credential: CSFA/CST
Phone: 715-581-9861