Organization
PREMIER PHYSICAL MEDICINE AND WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES E MULLEN M.D. (OWNER)
(715) 356-9999
Entity
Organization
Contact information
Practice address
1446 1ST AVE, WOODRUFF, WI 54568-9149
(715) 356-9999
(715) 356-9894
Mailing address
PO BOX 1550, WOODRUFF, WI 54568-1550
(715) 356-9999
(715) 356-9894
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
33657
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21307000
—
WI
Enumeration date
10/06/2006
Last updated
01/08/2009
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