NPI 1245580265
Willow Tree Support Services LLC
Practice location
- Address
- 2905 W 9th Ave, Oshkosh, WI 54904-6504
- Phone
- (920) 379-4388
Authorised official
- Name
- Jacob Tetzlaff
- Title
- Owner
- Phone
- (920) 379-4388
Registered specialties
In Home Supportive Care Agency
Primary
Registry record
- NPI
- 1245580265
- Entity type
- Organization
- NPI issued
- 17 Sep 2012
- Record last updated
- 17 Sep 2012
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.