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1720784242
WELLINGTON PROVIDER GROUP PC
MILWAUKEE, WI
NPI
1720784242
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Entity Type
Organization
Authorized Contact
MARIELA BRAVO
Credentialing Specialist
859-518-8817
Organization Subpart ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2023-02-06
Last Update Date
2023-02-06
Business Address
WELLINGTON PROVIDER GROUP PC
1433 N WATER ST STE 400
MILWAUKEE, WI 53202-2603
Phone number: 859-518-8817
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Mailing Address
WELLINGTON PROVIDER GROUP PC
535 WELLINGTON WAY STE 330
LEXINGTON, KY 40503-1331
Phone number: 859-518-8817
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