| NPI | 1114766805 |
|---|---|
| Doing Business As | LEADING EDGE CLINIC |
| Entity Type | Organization |
| Authorized Contact | TISHA PALMER Practice Manager 608-400-0141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 364S00000X Clinical Nurse Specialist | |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-05-22 |