| Brazeal Llc | |
|
197 W Chestnut St Burlington WI 53105-1200 | |
| (520) 236-3343 | |
| Not Available |
| Full Name | Brazeal Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 197 W Chestnut St, Burlington, Wisconsin |
| Authorized Official Name and Position | Michael Brazeal (STUDENT INTERN) |
| Authorized Official Contact | 5202363343 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brazeal Llc 4255 Wilderness Dr Mt Pleasant WI 53403-4400 Ph: (520) 236-3343 | Brazeal Llc 197 W Chestnut St Burlington WI 53105-1200 Ph: (520) 236-3343 |
| NPI Number | 1184309668 |
|---|---|
| Provider Enumeration Date | 06/21/2023 |
| Last Update Date | 06/21/2023 |
| Certification Date | 06/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184309668 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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