Organization
MMC MRI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNIE WIESMUELLER (DIRECTOR)
(262) 541-8020
Entity
Organization
Contact information
Practice address
1111 DELAFIELD ST, SUITE 301, WAUKESHA, WI 53188-3417
(262) 541-8020
(262) 650-4398
Mailing address
1111 DELAFIELD ST, SUITE 301, WAUKESHA, WI 53188-3417
(262) 541-8020
(262) 650-4398
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21268000
—
WI
Enumeration date
10/07/2005
Last updated
08/22/2020
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