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Organization
RELIV OF SOUTHERN WISCONSIN
Active
Organization
RELIV OF SOUTHERN WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VITTORIO GIUSEPPE SPADARO SR. (CHAIRMAN VP NUTRITION)
(920) 356-0681
Entity
Organization
Contact information
Practice address
201 PRAIRIE VIEW DR, BEAVER DAM, WI 53916-3406
(920) 356-0681
Mailing address
305 S CLARK ST, MAYVILLE, WI 53050-1488
(920) 356-0681
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
Other
Enumeration date
02/09/2009
Last updated
02/10/2009
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