| Prohealth Medical Group Inc | |
|
1279 Capitol Dr Pewaukee WI 53072-2504 | |
| (262) 928-9180 | |
| Not Available |
| Full Name | Prohealth Medical Group Inc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1279 Capitol Dr, Pewaukee, Wisconsin |
| Authorized Official Name and Position | Thomas W Johnson (REIMBURSEMENT MANAGER) |
| Authorized Official Contact | 2629284704 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prohealth Medical Group Inc N17w24100 Riverwood Dr Waukesha WI 53188-1127 Ph: (262) 928-4704 | Prohealth Medical Group Inc 1279 Capitol Dr Pewaukee WI 53072-2504 Ph: (262) 928-9180 |
| NPI Number | 1538839618 |
|---|---|
| Provider Enumeration Date | 09/20/2021 |
| Last Update Date | 05/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538839618 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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