Organization
WISCONSIN COMMUNITY SERVICES, INC. DRUG EVALUATION LABORATORY
Active
Organization
WISCONSIN COMMUNITY SERVICES, INC. DRUG EVALUATION LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLIS PATZER (EXECUTIVE DIRECTOR)
(414) 290-0418
Entity
Organization
Contact information
Practice address
949 N 9TH ST, ROOM 131E, MILWAUKEE, WI 53233-1422
(414) 223-1329
(414) 223-1836
Mailing address
3732 W WISCONSIN AVE, SUITE 200, MILWAUKEE, WI 53208-3153
(414) 290-0400
(414) 271-4605
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2133-800
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32920400
—
WI
Enumeration date
04/10/2007
Last updated
07/30/2007
Update your record
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