Retzlaff, Bruce W
Retzlaff, Bruce W is an individual health care provider with primary practice located at 501 Park Ave , Oconto WI 54153-1612. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Retzlaff, Bruce W can be contacted via phone (920) 834-7000.Contact Information
Primary practice address
501 Park Ave
Oconto WI 54153-1612
Phone: (920) 834-7000
Fax: (920) 834-6889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
| NPI number | 1154478634 |
|---|---|
| LBN Legal business name | Retzlaff, Bruce W |
| Credentials | MSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 5th, 2007 |
| Last updated | Jun 8th, 2011 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154478634 | NPPES |
| Wisconsin | MEDICAID | 43427200 | |
| Wisconsin | MEDICAID | 32980400 | |
| Wisconsin | MEDICAID | 42140300 |
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