Organization
COLUMBIA CORRECTIONAL INSTITUTION
Active
Other names
CCI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALIA SULIENE MD (PHYSICIAN)
(608) 742-9100
Entity
Organization
Contact information
Practice address
2925 COLUMBIA DR, PORTAGE, WI 53901-9485
(608) 742-9100
Mailing address
2925 COLUMBIA DR, PORTAGE, WI 53901-9485
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
28096
WI
Other
Enumeration date
02/08/2007
Last updated
05/23/2008
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