Organization
PRODESSE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MIHALOV M.D. (LABORATORY DIRECTOR)
(773) 792-5046
Entity
Organization
Contact information
Practice address
W229N1870 WESTWOOD DR, WAUKESHA, WI 53186-1302
(262) 446-0700
(262) 446-0600
Mailing address
W229N1870 WESTWOOD DR, WAUKESHA, WI 53186-1302
(262) 446-0700
(262) 446-0600
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
52D0906595
WI
Other
Enumeration date
04/26/2007
Last updated
07/22/2008
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