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General NPI Number Information
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NPI Number | 1083050942
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Entity Type | Organization
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Legal Business Name | VETERINARY CLINIC BERLIN/RIPON
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Dates
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Enumeration Date | 05/20/2013
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Last Update Date | 05/20/2013
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Provider Practice Location Address
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Address Line | W1915 CTY ROAD F
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City | BERLIN
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State | WI
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Zip | 54923
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Country | US
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Telephone | 920-361-2101
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Fax | 920-361-2150
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Provider Business Mailing Address
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Address Line | W1915 CTY ROAD F
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City | BERLIN
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State | WI
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Zip | 54923
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Country | US
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Telephone | 920-361-2101
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Fax | 920-361-2150
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. GARY J BATENHORST
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Credential | DVM
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Telephone | 920-361-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 2029
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License Number State | WI
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