Organization
PREMIER PHYSICAL MEDICINE AND WELLNESS CLINIC
Active
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
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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