Organization
ACTIVATE HEALTHCARE - TEAMSTERS 175 & 505 CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA GEIHSLER (PRINCIPAL)
(773) 697-3144
Entity
Organization
Contact information
Practice address
428 DIVISION ST, SUITE 2, SOUTH CHARLESTON, WV 25309-1469
(304) 768-0321
(304) 768-0322
Mailing address
2010 N DAMEN AVE, SUITE F, CHICAGO, IL 60647-3284
(773) 697-3144
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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