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Organization

DIRECT CARE PRENATAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DETRA FERGUSON-CALLAHAN (OWNER)
(414) 213-3966
Entity
Organization

Contact information

Practice address
11805 W HAMPTON AVE STE 103, MILWAUKEE, WI 53225
(414) 213-3966
(414) 755-7676
Mailing address
11805 W HAMPTON AVE STE 103, MILWAUKEE, WI 53225-3612
(414) 213-3966
(414) 755-7676

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Enumeration date
07/12/2018
Last updated
07/19/2018
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