Organization
HOMETOWN PHYSICIAN SERVICES MD, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY HENDRICKS (MSO ADMINISTRATOR)
(617) 304-2262
Entity
Organization
Contact information
Practice address
401 FINVOLD ST, WOODVILLE, WI 54028
(617) 304-2262
Mailing address
401 FINVOLD ST, WOODVILLE, WI 54028-9719
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/09/2018
Last updated
12/16/2019
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