# CHAMPION'S COACHING PATIENT SUPPORT AND COMPLIANCE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Champion's Coaching
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033498811
- **Authorized official:** MRS. DEIDRA C HALL (OWNER/CERTIFIED COACH)
- **Authorized official phone:** (414) 502-9090

## Contact information

- **Practice address:** 6520 W MOLTKE AVE, MILWAUKEE, WI 53210-1316
- **Practice address phone:** (414) 502-9090
- **Practice address fax:** (414) 395-3947
- **Mailing address:** 6520 W MOLTKE AVE, MILWAUKEE, WI 53210-1316
- **Mailing address phone:** (414) 502-9090
- **Mailing address fax:** (414) 395-3947

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | — | NULL | Yes |
| 174H00000X | Health Educator | — | — | Yes |

## Other

- **Enumeration date:** 08/10/2011
- **Last updated:** 08/10/2011