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 |