NPI 1922400563

Amanda Deremo

Organisation Exclusive Provider Organization Janesville, WI

Practice location

Address: 82 Falling Creek Cir, Janesville, WI 53548-9106
Phone: (608) 449-1399

Authorised official

Name: Amanda Deremo
Title: Employer
Phone: (608) 449-1399

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 318603 (WI)

Other Exclusive Provider Organization providers in Wisconsin →

Registry record

NPI: 1922400563
Entity type: Organization
NPI issued: 25 Sep 2014
Record last updated: 25 Sep 2014

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.