Organization
INTERRA HEALTH INC.
Active
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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