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1174291025
IMPACT PHYSICIAN GROUP, WISCONSIN LLC
MILWAUKEE, WI
NPI
1174291025
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Entity Type
Organization
Authorized Contact
PAUL MILLER
CEO
678-967-5599
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
Enumeration Date
2021-09-03
Last Update Date
2022-12-19
Business Address
IMPACT PHYSICIAN GROUP, WISCONSIN LLC
3200 S 103RD ST
MILWAUKEE, WI 53227-4104
Phone number: 469-640-6500
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Mailing Address
IMPACT PHYSICIAN GROUP, WISCONSIN LLC
21 EASTBROOK BND STE 218
PEACHTREE CITY, GA 30269-1546
Phone number: 678-967-5599
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