Organization
H2O:HEALTH HYDRATION OASIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIA LYNELL FOX MD (FOUNDER, MEDICAL DIRECTOR)
(269) 998-0683
Entity
Organization
Contact information
Practice address
17110 W GREENFIELD AVE STE 6, BROOKFIELD, WI 53005-6899
(269) 998-0683
Mailing address
13130 WATERTOWN PLANK RD UNIT 201, ELM GROVE, WI 53122-2240
(269) 998-0683
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
55919-20
WI
Other
Enumeration date
08/08/2017
Last updated
08/08/2017
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