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General NPI Number Information
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NPI Number | 1306483508
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Entity Type | Organization
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Legal Business Name | ACHIEVE WELLNESS CLINIC
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 03/21/2024
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Provider Practice Location Address
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Address Line | 1417 WINCHESTER WAY SUITE 6
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City | ALTOONA
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State | WI
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Zip | 54720-5472
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Country | US
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Telephone | 715-514-4734
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Fax | 715-832-9574
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Provider Business Mailing Address
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Address Line | 3300 BIRCH ST STE 1B
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City | EAU CLAIRE
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State | WI
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Zip | 54703-2297
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Country | US
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Telephone | 715-832-9467
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Fax | 715-832-9574
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | CATHERINE GUILLIAMS-CHAN
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Credential |
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Telephone | 715-832-9467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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