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 |