Organization
MEDEXPRESS PRIMARY CARE WISCONSIN, S.C.
Active
Other names
Waupaca Foundry
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT GALL (DIRECTOR PAYOR CONTRACTING)
(304) 225-2500
Entity
Organization
Contact information
Practice address
N2610 STATE ROAD 22 STE 2, WAUPACA, WI 54981-8264
(304) 225-2500
Mailing address
1001 CONSOL ENERGY DR, CANONSBURG, PA 15317-6506
(304) 225-2500
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/04/2021
Last updated
02/04/2021
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