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 |