| Advanced Therapies Llc | |
|
4402 S 68th St Ste104 Greenfield WI 53220-3479 | |
| (262) 506-4050 | |
| Not Available |
| Full Name | Advanced Therapies Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4402 S 68th St, Greenfield, Wisconsin |
| Authorized Official Name and Position | Mary Beth Layden (OWNER) |
| Authorized Official Contact | 2625064050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Therapies Llc 4402 S. 68th St. Ste104 Greenfeild WI 53220 Ph: (262) 506-4050 | Advanced Therapies Llc 4402 S 68th St Ste104 Greenfield WI 53220-3479 Ph: (262) 506-4050 |
| NPI Number | 1528503497 |
|---|---|
| Provider Enumeration Date | 12/30/2016 |
| Last Update Date | 12/30/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528503497 | NPI | - | NPPES |
| 1295856219 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 2417-123 (Wisconsin) | Primary |
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