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Organization

FAMILY TIES PRENATAL CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMIKO WILDER (CEO)
(414) 732-5160
Entity
Organization

Contact information

Practice address
5215 N IRONWOOD RD STE 202, GLENDALE, WI 53217-4908
(414) 338-6119
Mailing address
5215 N IRONWOOD RD STE 202, GLENDALE, WI 53217-4908
(414) 338-6119

Taxonomy

Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
Primary

Other

Enumeration date
12/30/2022
Last updated
12/30/2022
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