West Bend Clinic, Inc.

NPI #1326057795 in Hartford, Wisconsin

Provider Information

NPI Number: 1326057795
Entity Type: Organization
Organization Name: West Bend Clinic, Inc.
Primary Specialty: Family Medicine
Enumeration Date: Aug 5, 2006
Last Updated: May 23, 2012

Practice Location

Address: 110 LONE OAK LN
City: Hartford
State: Wisconsin
ZIP Code: 53027-2600
Phone: (262) 670-1800

Authorized Official

Name: GREGORY G BLOMMEL
Title: MEDICAL DIRECTOR
Phone: (262) 334-3451

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Obstetrics & Gynecology	207V00000X
Durable Medical Equipment & Medical Supplies	332B00000X
Family Medicine	207Q00000X	Primary

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