Organization
PROHEALTH MEDICAL GROUP INC
Active
Parent organization
PROHEALTH MEDICAL GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROHEALTH MEDICAL GROUP INC
Authorized official
THOMAS W JOHNSON (REIMBURSEMENT MANAGER)
(262) 928-4704
Entity
Organization
Contact information
Practice address
808 CORNERSTONE CT, WATERFORD, WI 53185-4562
(262) 928-1977
Mailing address
N17W24100 RIVERWOOD DR, WAUKESHA, WI 53188-1127
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/20/2021
Last updated
01/22/2025
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