Organization
FORWARD KETAMINE OF WISCONSIN S.C.
Active
Other names
Forward Ketamine
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW VASEY (PRESIDENT)
(608) 898-4818
Entity
Organization
Contact information
Practice address
221 KING ST, MADISON, WI 53703-3419
(608) 898-4818
Mailing address
221 KING ST, MADISON, WI 53703-3419
(608) 898-4818
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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