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Organization

INTERRA HEALTH INC.

Active
Other names
Three Waves InHealth Clinic and Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KYLE HANSEN MD (CHIEF MEDICAL OFFICER)
(414) 755-4898
Entity
Organization

Contact information

Practice address
1675 N BARKER RD, SUITE 200, BROOKFIELD, WI 53045-5200
(414) 755-4898
Mailing address
292 OHIO ST, OSHKOSH, WI 54902-5825
(920) 267-5332

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
43771-20
WI

Other

Enumeration date
09/26/2016
Last updated
09/26/2016
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