| |
309 E North St, Waukesha, WI 53188-3718 | |
(414) 672-1353 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 309 E North St, Waukesha, Wisconsin |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1083679385 | NPI | - | NPPES |
32958300 | Medicaid | WI |
Mailing Address | Practice Location Address |
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2906 S 20th St, Milwaukee, WI 53215-3732 Ph: (414) 672-1353 | 309 E North St, Waukesha, WI 53188-3718 Ph: (414) 672-1353 |