Antigo Medical Building, Llc | |
1111 Langlade Rd Antigo WI 54409-2787 | |
(715) 623-3761 | |
(715) 623-3764 |
Full Name | Antigo Medical Building, Llc |
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Speciality | Family Medicine |
Location | 1111 Langlade Rd, Antigo, Wisconsin |
Authorized Official Name and Position | Michelle Undeen (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 2394271257 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Antigo Medical Building, Llc 1111 Langlade Rd Antigo WI 54409-2787 Ph: (715) 623-3761 | Antigo Medical Building, Llc 1111 Langlade Rd Antigo WI 54409-2787 Ph: (715) 623-3761 |
NPI Number | 1396575353 |
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Provider Enumeration Date | 08/05/2024 |
Last Update Date | 08/05/2024 |
Identifier | Type | State | Issuer |
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1396575353 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |