Stockbridge Munsee Community

NPI #1942331467 in Bowler, Wisconsin

Provider Information

NPI Number: 1942331467
Entity Type: Organization
Organization Name: Stockbridge Munsee Community
Primary Specialty: Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Enumeration Date: Mar 8, 2007
Last Updated: Dec 4, 2008

Practice Location

Address: W12802 COUNTY ROAD A
City: Bowler
State: Wisconsin
ZIP Code: 54416-0086
Phone: (715) 793-4144

Authorized Official

Name: ROBERT CHICKS
Title: PRESIDENT
Phone: (715) 793-4111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy	332800000X	Primary

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