Organization
RELIV OF SOUTHERN WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VITTORIO GIUSEPPE SPADARO SR. (CHAIRMAN VP NUTRITION)
(920) 356-0681
Entity
Organization
Contact information
Practice address
201 PRAIRIE VIEW DR, BEAVER DAM, WI 53916-3406
(920) 356-0681
Mailing address
305 S CLARK ST, MAYVILLE, WI 53050-1488
(920) 356-0681
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/09/2009
Last updated
02/10/2009
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