Organization
PHYSICAL MEDICINE INSTITUTE OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT RISE (PRESIDENT)
(262) 200-2700
Entity
Organization
Contact information
Practice address
1370 PADST FARMS CIRCLE, SUITE 345, OCONOMOWOC, WI 53066-4879
(262) 200-2700
Mailing address
1370 PADST FARMS CIRCLE, SUITE 345, OCONOMOWOC, WI 53066-4879
(262) 200-2700
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2772820
WI
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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