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Organization
BYRON HEALTH AND HEALING CENTER
Active
Organization
BYRON HEALTH AND HEALING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K IRUNGU (BILLING MANAGER)
(678) 353-7073
Entity
Organization
Contact information
Practice address
2405 NORTHWESTERN AVE, LOWER LEVEL, STE 15, RACINE, WI 53404-2534
(262) 498-3718
Mailing address
2405 NORTHWESTERN AVE, LOWER LEVEL, STE 15, RACINE, WI 53404-2534
(262) 498-3718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42218-20
WI
207QA0401X
Addiction Medicine (Family Medicine) Physician
42218-20
WI
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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