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General NPI Number Information
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NPI Number | 1154318657
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Entity Type | Organization
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Legal Business Name | WINNEBAGO COUNTY
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 725 BUTLER AVE
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City | WINNEBAGO
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State | WI
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Zip | 54985-0068
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Country | US
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Telephone | 920-232-3000
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Fax | 920-303-3023
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Provider Business Mailing Address
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Address Line | PO BOX 68 725 BUTLER AVE
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City | WINNEBAGO
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State | WI
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Zip | 54985-0068
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Country | US
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Telephone | 920-232-3000
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Fax | 920-303-3023
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Authorized Official
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Title or Position | DIRECTOR/HEALTH OFFICER
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Name | DOUGLAS GIERYN
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Credential | B.S.
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Telephone | 920-232-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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