Organization
WAUKESHA FAMILY PRACTICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRIS C PURDY RN (PROGRAM ADMINISTRATOR)
(262) 548-6916
Entity
Organization
Contact information
Practice address
210 NW BARSTOW ST, SUITE 201, WAUKESHA, WI 53188-3771
(262) 548-6903
(262) 928-4075
Mailing address
210 NW BARSTOW ST, SUITE 201, WAUKESHA, WI 53188-3771
(262) 548-6903
(262) 928-4075
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32739000
—
WI
Enumeration date
03/16/2007
Last updated
06/20/2008
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