Organization
INTEGRATIVE HEALTH CENTER OF CENTRAL WISCONSIN LLC
Active
Other names
Integrative Health Center of Central Wisconsin LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN COTTER MD (OWNER)
(608) 222-2700
Entity
Organization
Contact information
Practice address
3205 E WASHINGTON AVE STE A, MADISON, WI 53704-4332
(608) 222-2700
(608) 222-2771
Mailing address
3205 E WASHINGTON AVE STE A, MADISON, WI 53704-4332
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34668700
—
WI
Enumeration date
10/25/2019
Last updated
01/20/2020
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