Grote, Gary Gene
Grote, Gary Gene is an individual health care provider with primary practice located at 114 Grand Ave , Wausau WI 54403-6214. 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. Grote, Gary Gene can be contacted via phone (715) 845-7175.Contact Information
Primary practice address
114 Grand Ave
Wausau WI 54403-6214
Phone: (715) 845-7175
Fax: (715) 845-7142
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 15180 | Wisconsin |
Profile Details
| NPI number | 1457493280 |
|---|---|
| LBN Legal business name | Grote, Gary Gene |
| Credentials | CSAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 12th, 2007 |
| Last updated | Nov 9th, 2016 - about 8 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 | 1457493280 | NPPES |
| Wisconsin | MEDICAID | 39174300 |
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