Individual
DAN THOMAS CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1185 CORPORATE CENTER DR, PROHEALTH CARE MEDICAL ASSOCIATES, OCONOMOWOC, WI 53066-4887
(262) 928-8400
(262) 928-8484
Mailing address
1185 CORPORATE CENTER DR, PROHEALTH CARE MEDICAL ASSOCIATES, OCONOMOWOC, WI 53066-4887
(262) 928-8400
(262) 928-8484
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21232
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30106700
—
WI
Enumeration date
08/31/2006
Last updated
01/18/2012
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