Organization
PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C.
Active
Other names
Harley Davidson Health Center-Tomahawk
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN M.D. (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
426 E SOMO AVE, TOMAHAWK, WI 54487-1536
(715) 453-1768
(715) 453-0540
Mailing address
1690616906 COLLECTIONS CTR DR, CHICAGO, IL 60693-0169
(715) 453-1768
(715) 453-0540
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
10/12/2011
Last updated
08/15/2022
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