Organization
HORIZON HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN MATAVKA (VICE PRESIDENT)
(414) 376-5577
Entity
Organization
Contact information
Practice address
719 W MAIN ST, WAUTOMA, WI 54982-8503
(414) 376-5577
Mailing address
4650 S HOWELL AVE, MILWAUKEE, WI 53207-5906
(414) 376-5577
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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