| NPI | 1306238191 |
|---|---|
| Doing Business As | OAKLEAF CLINICS, SOUTHSIDE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHRIS R LONGBELLA Director 715-836-9242 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2022-09-21 |