Provider First Line Business Practice Location Address:
717 W MORELAND BLVD
Provider Second Line Business Practice Location Address:
PROHEALTH CARE MEDICAL ASSOCIATES INC
Provider Business Practice Location Address City Name:
WAUKESHA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53188-2432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-542-9100
Provider Business Practice Location Address Fax Number:
262-542-7366
Provider Enumeration Date:
03/30/2008