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Organization
MILWAUKEE INDONESIA MEDICAL CLINIC
Active
Organization
MILWAUKEE INDONESIA MEDICAL CLINIC
Active
Other names
Indonesia Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
HERR YANG (PRESIDENT)
(414) 397-1654
Entity
Organization
Contact information
Practice address
6300 N 76TH ST STE 250, MILWAUKEE, WI 53218-1208
(414) 446-4660
Mailing address
6300 N 76TH ST STE 250, MILWAUKEE, WI 53218-1208
(414) 446-4660
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
NULL
122300000X
Dentist
—
—
152W00000X
Optometrist
—
NULL
152W00000X
Optometrist
—
—
183500000X
Pharmacist
—
NULL
183500000X
Pharmacist
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/20/2015
Last updated
11/14/2016
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