| NPI | 1023484961 |
|---|---|
| Other Name | 12TH STREET URGENT CARE |
| Entity Type | Organization |
| Authorized Contact | CANDICE COLE CFO 414-935-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QU0200X Clinic/Center, Urgent Care | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-08-14 |
| Last Update Date | 2017-02-01 |