Organization
CLINICA LATINA, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANDRE LASHAWN TURNER (OFFICE MANAGER)
(414) 645-6665
Entity
Organization
Contact information
Practice address
1238 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2267
(414) 645-6665
(414) 645-6732
Mailing address
1238 S CESAR E CHAVEZ DR, MILWAUKEE, WI 53204-2267
(414) 645-6665
(414) 645-6732
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
19077
WI
Other
Enumeration date
07/06/2010
Last updated
07/06/2010
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