| Prolo & Integrated Medicine, Llc | |
|
532 Lafayette Rd Sparta NJ 07871-4411 | |
| (973) 362-5227 | |
| (973) 250-0045 |
| Full Name | Prolo & Integrated Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 532 Lafayette Rd, Sparta, New Jersey |
| Authorized Official Name and Position | Walter Grote (PROVIDER) |
| Authorized Official Contact | 9733625227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prolo & Integrated Medicine, Llc Po Box 297 Blairstown NJ 07825-0297 Ph: (973) 362-5227 | Prolo & Integrated Medicine, Llc 532 Lafayette Rd Sparta NJ 07871-4411 Ph: (973) 362-5227 |
| NPI Number | 1134470222 |
|---|---|
| Provider Enumeration Date | 09/28/2012 |
| Last Update Date | 09/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134470222 | NPI | - | NPPES |
| 0341401 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MB03954800 (New Jersey) | Primary |
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