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General NPI Number Information
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NPI Number | 1750896015
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Entity Type | Organization
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Legal Business Name | ASPIRUS MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 5409 VERN HOLMES DR
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City | STEVENS POINT
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State | WI
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Zip | 54482-8853
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Country | US
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Telephone | 715-847-2000
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Fax | 715-847-0005
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Provider Business Mailing Address
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Address Line | 29980 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1299
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Country | US
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Telephone | 715-847-2304
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Fax | 715-843-1188
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Authorized Official
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Title or Position | VP REVENUE CYCLE
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Name | LORI PECK
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Credential |
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Telephone | 715-847-2988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 43345-20
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License Number State | WI
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