Organization
AUTHENTIC BIRTH CENTER . WELLNESS COLLECTIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LANETTE JOY MCQUITTY LM, CPM (OWNER,)
(414) 559-2229
Entity
Organization
Contact information
Practice address
530 N 108TH PL, SUITE 100, WAUWATOSA, WI 53226-4253
(414) 559-2229
Mailing address
530 N 108TH PL, SUITE 100, WAUWATOSA, WI 53226-4253
(414) 559-2229
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary
—
WI
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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