Organization
GREAT HEALTH MEDICAL WI SC
Active
Organization
GREAT HEALTH MEDICAL WI SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZLAN TARIQ (OWNER)
(212) 734-6621
Entity
Organization
Contact information
Practice address
1905 W HART RD, BELOIT, WI 53511-2230
(718) 470-0288
Mailing address
407 WILLOUGHBY AVE, BROOKLYN, NY 11205-4590
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/09/2024
Last updated
09/17/2025
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