Organization
LIFEVIEW CARE WISCONSIN S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RAY HARMAN M.D. (MEDICAL DIRECTOR)
(952) 500-3337
Entity
Organization
Contact information
Practice address
3600 AMERICAN BLVD W STE 225, BLOOMINGTON, MN 55431-4527
(952) 500-3337
(855) 715-1907
Mailing address
901 S WHITNEY WAY, MADISON, WI 53711-2553
(952) 500-3337
(855) 715-1907
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609853530
PROVIDER NPI
—
Enumeration date
12/09/2011
Last updated
12/13/2011
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