SOUTH STREET CLINIC LLC

OCONOMOWOC, WI
NPI1235128356
Entity TypeOrganization
Authorized ContactANNE ALEXA WESTON
Clinic Owner
262-567-7673
Organization Subpart ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: WI  1841)
Enumeration Date2005-10-20
Last Update Date2020-08-22
Business Address
SOUTH STREET CLINIC LLC
416 W SOUTH ST
OCONOMOWOC, WI 53066-2755
Phone number: 262-567-7673
Mailing Address
SOUTH STREET CLINIC LLC
416 W SOUTH ST
OCONOMOWOC, WI 53066-2755
Phone number: 262-567-7673