| Ageless Wellness Center, Inc | |
|
2745 W Layton Ave Suite 203 Milwaukee WI 53221-2651 | |
| (414) 475-5800 | |
| (414) 475-5400 |
| Full Name | Ageless Wellness Center, Inc |
|---|---|
| Speciality | General Practice |
| Location | 2745 W Layton Ave, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Abdullattief A Sulieman (PRESIDENT/OWNER) |
| Authorized Official Contact | 4144755800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ageless Wellness Center, Inc Po Box 639 Thiensville WI 53092-0639 Ph: (414) 247-9005 | Ageless Wellness Center, Inc 2745 W Layton Ave Suite 203 Milwaukee WI 53221-2651 Ph: (414) 475-5800 |
| NPI Number | 1245672856 |
|---|---|
| Provider Enumeration Date | 07/24/2013 |
| Last Update Date | 05/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245672856 | NPI | - | NPPES |
| 1881864197 | Medicaid | WI | |
| K100110473 | Other | WI | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 51008 (Wisconsin) | Primary |
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