Provider First Line Business Practice Location Address:
13900 W. NATIONAL AVENUE
Provider Second Line Business Practice Location Address:
PROHEALTH CARE MEDICAL ASSOCIATES, INC.
Provider Business Practice Location Address City Name:
NEW BERLIN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-928-4500
Provider Business Practice Location Address Fax Number:
262-928-4550
Provider Enumeration Date:
02/10/2006