Organization
PRIMAL AIR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP AIR GUTKOWSKI (BUSINESS MANAGER)
(608) 373-4871
Entity
Organization
Contact information
Practice address
1266 W MAIN ST, SUN PRAIRIE, WI 53590-1918
(608) 318-2800
Mailing address
1266 W MAIN ST STE 2, SUN PRAIRIE, WI 53590-1922
(608) 373-4871
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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