Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

West Bend Clinic, Inc

Organization Dermatology Physician · NPI 1043220692

West Bend Clinic, Inc is a Dermatology Physician in West Bend, Wisconsin. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
8
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1190 E Paradise Dr
West Bend, WI 53095-5444
Phone: (262) 306-6319
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Dermatology Physician Taxonomy 207N00000X
Plastic and Reconstructive Surgery Physician Taxonomy 2086S0122X
Occupational Therapy Assistant Taxonomy 224Z00000X
Physical Therapy Assistant Taxonomy 225200000X
Occupational Therapist Taxonomy 225X00000X
Speech-Language Pathologist Taxonomy 235Z00000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1043220692
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gregory Blommel — Administrator · (262) 334-3451
Other names West Bend Clinic East
NPI enumeratedAugust 8, 2006
Last updated in NPPESMay 23, 2012
Mailing address1700 W Paradise Dr, West Bend, WI 53095-9795

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