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Organization

PAIN MANAGEMENT & HEALTHCARE OF WEST ALLIS, LLC

Active
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Organization

PAIN MANAGEMENT & HEALTHCARE OF WEST ALLIS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BARBARA J JOHNSON FARMER RN, ARNP, FNP, PHD (OWNER, CEO)
(414) 777-5066
Entity
Organization

Contact information

Practice address
6751 W GREENFIELD AVE, WEST ALLIS, WI 53214-4966
(414) 777-5066
(414) 777-5067
Mailing address
6751 W GREENFIELD AVE, WEST ALLIS, WI 53214-4966
(414) 777-5066
(414) 777-5067

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
2798-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100040897
WI
05
1306947817
WI
Enumeration date
10/29/2013
Last updated
08/04/2015
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