Organization
RACHAEL WEIDERHOLD D.O. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHAEL LYNN GATES D.O. (OWNER)
(414) 545-5542
Entity
Organization
Contact information
Practice address
9004 W LINCOLN AVE, SUITE 101, WEST ALLIS, WI 53227-2452
(414) 545-5542
(414) 545-5548
Mailing address
9004 W LINCOLN AVE, SUITE 101, WEST ALLIS, WI 53227-2452
(414) 545-5542
(414) 545-5548
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32395
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30057700
—
WI
Enumeration date
07/30/2006
Last updated
11/04/2013
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