| NPI | 1699534545 |
|---|---|
| Doing Business As | PRAIRIE RIDGE HEALTH CLINIC-SUN PRAIRIE |
| Entity Type | Organization |
| Authorized Contact | MELISSA MANGAN CFO 920-623-1369 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-14 |