Gragg, Jr., Neil B

Gragg, Jr., Neil B is an individual health care provider with primary practice located at 519 Midland Ct Suite #102, Janesville WI 53546-2336. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gragg, Jr., Neil B can be contacted via phone (608) 756-9090.

Contact Information

Primary practice address
519 Midland Ct Suite #102 Janesville WI 53546-2336
Phone: (608) 756-9090
Fax: (608) 756-2920
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 809-123 Wisconsin

Profile Details

NPI number 1407897242
LBN Legal business name Gragg, Jr., Neil B
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2006
Last updated Jul 9th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407897242 NPPES
Wisconsin MEDICAID 39543800

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