Organization
NUDERMA MED SPA AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN HANSON (PRESIDENT)
(262) 716-7580
Entity
Organization
Contact information
Practice address
N14W23777 STONE RIDGE DR STE 290, WAUKESHA, WI 53188-1140
(262) 716-7580
Mailing address
N14W23777 STONE RIDGE DR STE 290, WAUKESHA, WI 53188-1140
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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