| East Town Professional Associates, S.c. | |
|
1017 W Glen Oaks Ln Suite 201 Mequon WI 53092-3371 | |
| (262) 241-3698 | |
| Not Available |
| Full Name | East Town Professional Associates, S.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1017 W Glen Oaks Ln, Mequon, Wisconsin |
| Authorized Official Name and Position | Christina C Keppel (PRESIDENT) |
| Authorized Official Contact | 2622413698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Town Professional Associates, S.c. 1017 W Glen Oaks Ln Suite 201 Mequon WI 53092-3371 Ph: (262) 241-3698 | East Town Professional Associates, S.c. 1017 W Glen Oaks Ln Suite 201 Mequon WI 53092-3371 Ph: (262) 241-3698 |
| NPI Number | 1669411567 |
|---|---|
| Provider Enumeration Date | 06/06/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669411567 | NPI | - | NPPES |
| 42236200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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