Organization
PPM WISCONSIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER L TUELLER (SECRETARY)
(208) 207-2726
Entity
Organization
Contact information
Practice address
W175N11117 STONEWOOD DR STE 100, GERMANTOWN, WI 53022-6505
(888) 253-6598
Mailing address
W175N11117 STONEWOOD DR STE 100, GERMANTOWN, WI 53022-6505
(888) 253-6598
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/05/2023
Last updated
06/06/2025
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