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General NPI Number Information
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NPI Number | 1487755179
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Entity Type | Organization
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Legal Business Name | LAFAYETTE COUNTY
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 800 CLAY ST
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City | DARLINGTON
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State | WI
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Zip | 53530-1228
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Country | US
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Telephone | 608-776-4466
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Fax | 608-776-5701
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Provider Business Mailing Address
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Address Line | P.O. BOX 70
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City | DARLINGTON
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State | WI
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Zip | 53530-1228
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Country | US
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Telephone | 608-776-4466
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Fax | 608-776-5701
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JULIE M. CHIKOWSKI
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Credential |
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Telephone | 608-776-4466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 1015
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License Number State | WI
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