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NPI Code Detail

MEDICARE: RICHARD WILLIAM POLZIN

MEDICARE: RICHARD WILLIAM POLZIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist745WI

General Provider Information

NPI Number : 1205392875
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD WILLIAM POLZIN
Provider Business Mailing Address
First Line : 405 W VINE ST
Second Line :
City : CHIPPEWA FALLS
State : WI
Zip : 54729-3026
Country : US
Telephone Number : 715-723-8097
Fax Number :
Provider Business Practice Location Address
First Line : 1791 COUNTY HIGHWAY OO
Second Line :
City : CHIPPEWA FALLS
State : WI
Zip : 54729-5347
Country : US
Telephone Number : 715-830-4055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2019
Last Update Date : 02/19/2019

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