Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID VAN THIEL MSW (SOCIAL WORK EXECUTIVE)
(414) 384-2000
Entity
Organization
Contact information
Practice address
21425 SPRING ST, UNION GROVE, WI 53182-9707
(262) 878-7024
Mailing address
5000 W NATIONAL AVE, MILWAUKEE, WI 53295-0001
(414) 384-2000
(414) 389-4199
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
126683-121
WI
Other
Enumeration date
11/05/2010
Last updated
11/05/2010
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