Defatta ENT & Facial Plastic Surgery SC
Defatta ENT & Facial Plastic Surgery SC is a Specialist in Altoona, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2014.
- Licensed in
- WI
- In the registry since
- 2014
- Specialties on file
- 2
Practice location Address checks out
1490 Rivers Edge TrlAltoona, WI 54720-1495
Phone: (715) 828-2368
Fax: (715) 726-2087
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Specialist (primary) | Taxonomy 174400000X · Licence 55984-20 (WI) |
|---|---|
| Medical Specialty Clinic/Center | Taxonomy 261QM2500X · Licence 55984-20 (WI) |
Record details
| NPI number | 1346664059 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Robert Defatta — Owner · (715) 828-2368 |
| NPI enumerated | February 17, 2014 |
| Last updated in NPPES | May 5, 2014 |
| Mailing address | 1490 Rivers Edge Trail, Altoona, WI 54720-1495 |