Provider First Line Business Practice Location Address:
N14W23900 STONE RIDGE DR
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:
53188-1135
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-549-3030
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/09/2006