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General NPI Number Information
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NPI Number | 1841387917
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Entity Type | Organization
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Legal Business Name | TWIN CITY ORTHOPAEDIC CLINIC SC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 2724 CAHILL RD
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City | MARINETTE
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State | WI
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Zip | 54143-3869
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Country | US
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Telephone | 715-732-4040
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Fax | 715-732-2621
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Provider Business Mailing Address
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Address Line | PO BOX 435
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City | MARINETTE
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State | WI
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Zip | 54143-0435
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Country | US
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Telephone | 715-732-4040
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Fax | 715-732-2621
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES TANDIAS
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Credential | MD
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Telephone | 715-732-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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