Gotz, Sandra

Gotz, Sandra is an individual health care provider with primary practice located at 9532 E 16 Frontage Rd , Onalaska WI 54650-6739. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Gotz, Sandra can be contacted via phone (608) 783-0506.

Contact Information

Primary practice address
9532 E 16 Frontage Rd Onalaska WI 54650-6739
Phone: (608) 783-0506
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Addiction (Substance Use Disorder) 163WA0400X 257499-30 Wisconsin

Profile Details

NPI number 1225634207
LBN Legal business name Gotz, Sandra
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2020
Last updated Dec 10th, 2020 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225634207 NPPES
Wisconsin MEDICAID 1003150004

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