T.D.C.

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

541-0001 Issued in WI

Legal business name

T.D.C.

Practice address

3000 Emery Dr
Wausau, WI 54401-9710

Phone

(715) 675-6771

NPI assigned

Aug 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jennifer Blahnik, O.M.D.

Title

Supervisor

Phone

(715) 675-6771

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1629269899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 EMERY DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019710",
            "telephone_number": "715-675-6771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 EMERY DR",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544019710",
            "telephone_number": "715-675-6771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T.D.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "BLAHNIK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "715-675-6771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.M.D."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "WI",
            "license": "541-0001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Wausau, WI
• Providers in Wausau, WI by specialty
• Physiological Laboratory in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.