| NPI | 1407202831 |
|---|---|
| Doing Business As | PREVEA KOHLER WOODLAKE |
| Entity Type | Organization |
| Authorized Contact | JUSTIN SELLE President And CEO 920-496-4700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 247100000X Radiologic Technologist | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2022-01-12 |