Organization
WISCONSIN WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MCNEIL (CEO)
(262) 373-9181
Entity
Organization
Contact information
Practice address
280 REGENCY CT, SUITE 100, BROOKFIELD, WI 53045-6165
(262) 373-9181
Mailing address
280 REGENCY CT, SUITE 100, BROOKFIELD, WI 53045-6165
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
WI
Other
Enumeration date
05/11/2014
Last updated
05/11/2014
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