Organization
MILWAUKEE INDONESIA MEDICAL CLINIC
Active
Other names
Indonesia Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
HERR YANG (PRESIDENT)
(414) 397-1654
Entity
Organization
Contact information
Practice address
6300 N 76TH ST STE 250, MILWAUKEE, WI 53218-1208
(414) 446-4660
Mailing address
6300 N 76TH ST STE 250, MILWAUKEE, WI 53218-1208
(414) 446-4660
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
152W00000X
Optometrist
—
—
183500000X
Pharmacist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/20/2015
Last updated
11/14/2016
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