| Antigo Medical Building, Llc | |
|
1111 Langlade Rd Antigo WI 54409-2787 | |
| (715) 623-3761 | |
| (715) 623-3764 |
| Full Name | Antigo Medical Building, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1111 Langlade Rd, Antigo, Wisconsin |
| Authorized Official Name and Position | Michelle Undeen (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2394271257 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Antigo Medical Building, Llc 1111 Langlade Rd Antigo WI 54409-2787 Ph: (715) 623-3761 | Antigo Medical Building, Llc 1111 Langlade Rd Antigo WI 54409-2787 Ph: (715) 623-3761 |
| NPI Number | 1396575353 |
|---|---|
| Provider Enumeration Date | 08/05/2024 |
| Last Update Date | 08/05/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396575353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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