| NPI | 1285900514 |
|---|---|
| Other Name | GL RIVERSIDE WELLNESS CLINIC |
| Entity Type | Organization |
| Authorized Contact | KARI B ADANK Cco 608-775-8025 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2021-08-06 |