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Organization
PRAIRIE RIDGE HEALTH INC.
Active
Organization
PRAIRIE RIDGE HEALTH INC.
Active
Parent organization
PRAIRIE RIDGE HEALTH, INC.
Other names
Prairie Ridge Health Clinic-Sun Prairie
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRAIRIE RIDGE HEALTH, INC.
Authorized official
MELISSA MANGAN (CFO)
(920) 623-1369
Entity
Organization
Contact information
Practice address
155 SOUTH MALLARD DRIVE, SUN PRAIRIE, WI 53590
(920) 623-2200
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-1618
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/14/2024
Last updated
03/14/2024
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