Organization
HONOR ON-SITE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FICK PA-C (OWNER/PHYSICIAN ASSISTANT)
(715) 558-3510
Entity
Organization
Contact information
Practice address
W183S8750 RACINE AVE # 3, MUSKEGO, WI 53150-8067
(262) 971-1798
(262) 679-1378
Mailing address
W179S6914 MUSKEGO DR, MUSKEGO, WI 53150-9631
(715) 558-3510
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932182177
BCBS WISCONSIN
—
05
—
42946900
—
WI
Enumeration date
05/15/2023
Last updated
05/15/2023
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