Organization
PROHEALTH MEDICAL GROUP INC
Active
Parent organization
PROHEALTH MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROHEALTH MEDICAL GROUP INC
Authorized official
PETER T GEISS MD (PRESIDENT)
(262) 928-8669
Entity
Organization
Contact information
Practice address
721 AMERICAN AVE, SUITE 309, WAUKESHA, WI 53188-5071
(262) 928-4455
(262) 928-4470
Mailing address
N17 W24100 RIVERWOOD DR, SUITE 250, WAUKESHA, WI 53188-1177
(262) 928-4100
(262) 928-5835
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0505180011
DME
WI
05
—
32854900
—
WI
Enumeration date
02/12/2007
Last updated
05/23/2022
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