| Amayla Empowerment Association, LLC | |
|
435 Julie St Ste 2 Tomah WI 54660-2924 | |
| (608) 377-3864 | |
| Not Available |
| Full Name | Amayla Empowerment Association, LLC |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 435 Julie St Ste 2, Tomah, Wisconsin |
| Authorized Official Name and Position | Amanda Falkers (CO-OWNER) |
| Authorized Official Contact | 6083773864 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amayla Empowerment Association, LLC 435 Julie St Ste 2 Tomah WI 54660-2924 Ph: (608) 377-3864 | Amayla Empowerment Association, LLC 435 Julie St Ste 2 Tomah WI 54660-2924 Ph: (608) 377-3864 |
| NPI Number | 1659065530 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 06/05/2023 |
| Certification Date | 06/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659065530 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
GL Tomah Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 505 Gopher Dr, Tomah, WI 54660 Phone: 608-782-7300 |