Midwest Integrated Medical Center Llc | |
2920 Enloe St Ste 105 Hudson WI 54016-8191 | |
(715) 808-0716 | |
Not Available |
Full Name | Midwest Integrated Medical Center Llc |
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Speciality | Clinic/center - Multi-specialty |
Location | 2920 Enloe St Ste 105, Hudson, Wisconsin |
Authorized Official Name and Position | Daryl Cooper (OWNER) |
Authorized Official Contact | 7158080716 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Midwest Integrated Medical Center Llc 2920 Enloe St Ste 105 Hudson WI 54016-8191 Ph: (715) 808-0716 | Midwest Integrated Medical Center Llc 2920 Enloe St Ste 105 Hudson WI 54016-8191 Ph: (715) 808-0716 |
NPI Number | 1770095796 |
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Provider Enumeration Date | 10/31/2017 |
Last Update Date | 01/22/2018 |
Identifier | Type | State | Issuer |
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1770095796 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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