Organization
GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN EISENBERG (MEDICAL STAFF ADMINISTRATOR)
(608) 251-4156
Entity
Organization
Contact information
Practice address
1265 JOHN Q HAMMONS DR, MADISON, WI 53717-1921
(608) 251-4156
Mailing address
1265 JOHN Q HAMMONS DR, MADISON, WI 53717-1921
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
261429
WI
Other
Enumeration date
07/17/2014
Last updated
07/17/2014
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