Prevea Kohler Woodlake | |
950 Woodlake Rd Kohler WI 53044-1348 | |
(920) 496-4700 | |
Not Available |
Full Name | Prevea Kohler Woodlake |
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Speciality | General Practice |
Location | 950 Woodlake Rd, Kohler, Wisconsin |
Authorized Official Name and Position | Justin Selle (PRESIDENT AND CEO) |
Authorized Official Contact | 9204964700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Prevea Kohler Woodlake Po Box 19070 Green Bay WI 54307-9070 Ph: (920) 496-4700 | Prevea Kohler Woodlake 950 Woodlake Rd Kohler WI 53044-1348 Ph: (920) 496-4700 |
NPI Number | 1407202831 |
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Provider Enumeration Date | 05/04/2016 |
Last Update Date | 01/12/2022 |
Identifier | Type | State | Issuer |
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1407202831 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Wisconsin) | Secondary |
208D00000X | General Practice | (Wisconsin) | Primary |
247100000X | Radiologic Technologist | (Wisconsin) | Secondary |