Organization
MIDWEST INTEGRATED MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYL COOPER DC (OWNER)
(715) 808-0716
Entity
Organization
Contact information
Practice address
2920 ENLOE ST STE 105, HUDSON, WI 54016-8191
(715) 808-0716
Mailing address
2920 ENLOE ST STE 105, HUDSON, WI 54016-8191
(715) 808-0716
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/31/2017
Last updated
01/22/2018
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