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General NPI Number Information
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NPI Number | 1609015569
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL HEALTH SERVICES INC.
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Dates
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Enumeration Date | 02/16/2009
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 2688 VISSERS CT
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City | GREEN BAY
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State | WI
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Zip | 54313-5856
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Country | US
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Telephone | 920-265-8829
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Fax | 920-498-8829
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Provider Business Mailing Address
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Address Line | 2688 VISSERS CT
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City | GREEN BAY
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State | WI
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Zip | 54313-5856
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Country | US
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Telephone | 920-265-8829
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Fax | 920-498-8829
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Authorized Official
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Title or Position | MD
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Name | DR. JOHN PATRICK KISER
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Credential | MD
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Telephone | 920-265-8829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 23110
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License Number State | WI
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