Wilber, Bruce A
Wilber, Bruce A is an sole proprietor health care provider with primary practice located at N2150 Kesaehkahtek Rd , Gresham WI 54128-9602. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Wilber, Bruce A can be contacted via phone (715) 799-3835.Contact Information
Primary practice address
N2150 Kesaehkahtek Rd
Gresham WI 54128-9602
Phone: (715) 799-3835
Fax: (715) 799-3836
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 15433131 | Wisconsin |
Profile Details
| NPI number | 1003063157 |
|---|---|
| LBN Legal business name | Wilber, Bruce A |
| Credentials | SAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 20th, 2008 |
| Last updated | Aug 20th, 2008 - about 18 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 | 1003063157 | NPPES |
| Wisconsin | MEDICAID | 41162800 |
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