Organization
PREVAIL PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN HANSON (OWNER)
(262) 716-7580
Entity
Organization
Contact information
Practice address
2222 N MAYFAIR RD, WAUWATOSA, WI 53226-2208
(262) 716-7580
Mailing address
2222 N MAYFAIR RD, WAUWATOSA, WI 53226-2208
(262) 716-7580
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
—
—
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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