Organization
FORWARD KETAMINE OF WISCONSIN S.C.
Active
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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