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General NPI Number Information
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NPI Number | 1407501059
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Entity Type | Organization
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Legal Business Name | AURORA COMMUNITY CLINIC SC
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Dates
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Enumeration Date | 02/12/2022
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Last Update Date | 02/12/2022
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Provider Practice Location Address
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Address Line | 123 W STATE ST
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City | MEDFORD
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State | WI
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Zip | 54451-1772
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Country | US
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Telephone | 157-484-4337
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Fax | 715-748-6304
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Provider Business Mailing Address
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Address Line | N4895 LANG FARM DR
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City | MEDFORD
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State | WI
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Zip | 54451-8889
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Country | US
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Telephone | 715-748-4433
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | DR. SAMUEL KLINNER
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Credential | DC
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Telephone | 715-748-4433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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