PROVIDENCE FAMILY MEDICAL CLINIC S.C

GLENDALE, WI
NPI1861857542
Entity TypeOrganization
Authorized ContactADEDAPO F OKUSANYA
President
269-598-7404
Organization Subpart ?No
Primary Taxonomy261QP2300X Clinic/Center, Primary Care
Enumeration Date2015-12-22
Last Update Date2015-12-22
Business Address
PROVIDENCE FAMILY MEDICAL CLINIC S.C
2500 W SILVER SPRING DR
GLENDALE, WI 53209-4218
Phone number: 414-800-7171
Mailing Address
PROVIDENCE FAMILY MEDICAL CLINIC S.C
2500 W SILVER SPRING DR
GLENDALE, WI 53209-4218
Phone number: 414-800-7171
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