North Shore Concierge Clinic

NPI 1336530336 - Family Medicine - 207Q00000X

NPI Details
NPI 1336530336
Enumeration Date 02/12/2015
Last Updated 02/12/2015
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name TRACY M TRACY
Position OWNER
Phone (262) 421-5133
Fax (855) 832-0258
Practice Location
W62N225 WASHINGTON AVE
CEDARBURG WI, 53012-2726, US
Phone (262) 421-5133
Fax (855) 832-0258
Business Location
W77N731 HARVEST LN
CEDARBURG WI, 53012-1744, US
Phone (715) 409-0565
Fax (855) 832-0258
Toxanomy
Taxonomy Code 207Q00000X
License State Wisconsin
License Number 52008-20
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According to our database, North Shore Concierge Clinic NPI is 1336530336, taxonomy code is 207Q00000X and license number is 52008-20, license state is located at Wisconsin. North Shore Concierge Clinic physically located at W62n225 Washington Ave, Cedarburg WI, 53012-2726. NPI Number 1033115704 has the healthcare provider type.

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1336530336 NPI number is provided on an as is basis without warranty of any kind. 1336530336 is maintained by the National Plan & Provider Enumeration System. The contents of North Shore Concierge Clinic are for informational purposes only.