| Premise Health Of Wisconsin Medical, S.c. | |
|
2222 Kwik Trip Way La Crosse WI 54603-3238 | |
| (608) 781-4460 | |
| (608) 781-5587 |
| Full Name | Premise Health Of Wisconsin Medical, S.c. |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2222 Kwik Trip Way, La Crosse, Wisconsin |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 6154686270 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Wisconsin Medical, S.c. 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Wisconsin Medical, S.c. 2222 Kwik Trip Way La Crosse WI 54603-3238 Ph: (608) 781-4460 |
| NPI Number | 1003591223 |
|---|---|
| Provider Enumeration Date | 06/15/2023 |
| Last Update Date | 06/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003591223 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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