Organization
PROCARE MEDICAL GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALINA VALLE (OFFICE MANAGER)
(414) 291-2624
Entity
Organization
Contact information
Practice address
3727 W WISCONSIN AVE, MILWAUKEE, WI 53208-3182
(414) 291-2626
(414) 291-2630
Mailing address
3727 W WISCONSIN AVE, MILWAUKEE, WI 53208-3182
(414) 291-2626
(414) 291-2630
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32808100
—
WI
Enumeration date
12/28/2006
Last updated
09/23/2021
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