Organization
LIFETIME CARE AT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FERDINAND BAUER (OWNER/PRESIDENT)
(612) 636-0751
Entity
Organization
Contact information
Practice address
W 7652 2090TH AVENUE, HAGAR CITY, WI 54014
(612) 636-0751
Mailing address
W 7652 2090TH AVENUE, HAGER CITY, WI 54014
(612) 636-0751
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
07/28/2009
Last updated
07/28/2009
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