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Organization
BROTOLOC INC. OUTPATIENT CLINIC
Active
Organization
BROTOLOC INC. OUTPATIENT CLINIC
Active
Other names
Brotoloc
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN MILLARD BA (DIRECTOR)
(262) 473-0480
Entity
Organization
Contact information
Practice address
209 S TAFT ST, WHITEWATER, WI 53190-2139
(262) 473-0480
(262) 473-0484
Mailing address
209 S TAFT ST, WHITEWATER, WI 53190-2139
(262) 473-0480
(262) 473-0484
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1115
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42181100
—
WI
Enumeration date
02/12/2007
Last updated
08/22/2020
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