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General NPI Number Information
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NPI Number | 1073417531
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Entity Type | Organization
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Legal Business Name | GUNDERSEN CLINIC LTD
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 1111 W WISCONSIN ST
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City | SPARTA
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State | WI
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Zip | 54656-2233
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Country | US
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Telephone | 608-782-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 1836 SOUTH AVE
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City | LA CROSSE
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State | WI
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Zip | 54601-5429
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Country | US
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Telephone | 608-782-7300
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, REIMBURSEMENT
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Name | DEBRA L VAN PAY
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Credential |
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Telephone | 608-782-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | NULL
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