Donald E. Dlouhy Llc | |
12728 W Hampton Ave Butler WI 53007-1602 | |
(262) 781-8693 | |
(262) 781-1468 |
Full Name | Donald E. Dlouhy Llc |
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Speciality | Clinic/center |
Location | 12728 W Hampton Ave, Butler, Wisconsin |
Authorized Official Name and Position | Donald Edward Dlouhy (OWNER) |
Authorized Official Contact | 2627818693 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Donald E. Dlouhy Llc 12728 W Hampton Ave Butler WI 53007-1602 Ph: (262) 781-8693 | Donald E. Dlouhy Llc 12728 W Hampton Ave Butler WI 53007-1602 Ph: (262) 781-8693 |
NPI Number | 1215177167 |
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Provider Enumeration Date | 03/04/2009 |
Last Update Date | 01/06/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215177167 | NPI | - | NPPES |
38519900 | Medicaid | WI | |
DE41133 | Other | WI | SPECTERA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 1863-035 (Wisconsin) | Primary |