Organization
ANTIGO MEDICAL BUILDING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE UNDEEN (CREDENTIALING SPECIALIST)
(239) 427-1257
Entity
Organization
Contact information
Practice address
1111 LANGLADE RD, ANTIGO, WI 54409-2787
(715) 623-3761
(715) 623-3764
Mailing address
1111 LANGLADE RD, ANTIGO, WI 54409-2787
(715) 623-3761
(715) 623-3764
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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