| Prisma Wisconsin Llc | |
|
13500 Watertown Plank Rd Ste 102 Elm Grove WI 53122-2222 | |
| (206) 785-1015 | |
| (206) 785-1023 |
| Full Name | Prisma Wisconsin Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 13500 Watertown Plank Rd Ste 102, Elm Grove, Wisconsin |
| Authorized Official Name and Position | Scott Wiener (MEDICAL DIRECTOR) |
| Authorized Official Contact | 2069391079 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prisma Wisconsin Llc 2031 Ridge End Rd Virginia Beach VA 23454-1028 Ph: (206) 939-1079 | Prisma Wisconsin Llc 13500 Watertown Plank Rd Ste 102 Elm Grove WI 53122-2222 Ph: (206) 785-1015 |
| NPI Number | 1497519979 |
|---|---|
| Provider Enumeration Date | 02/06/2024 |
| Last Update Date | 02/06/2024 |
| Certification Date | 02/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497519979 | NPI | - | NPPES |
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