Integrative Medicine Lake Country, LLC
Clinic/Center, Medical Specialty in Hartland, WI. Organization (NPI-2).
NPI number1235945346
StatusActive
Last updated in NPPESDec 4, 2024
Details
- NPI
- 1235945346
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrative Medicine Lake Country, LLC
- Organization subpart
- No
- Enumeration date
- Dec 4, 2024
- Certification date
- Dec 4, 2024
- Last updated
- Dec 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | – | – | Yes |
Practice location
138 North Ave Ste 4Hartland, WI 53029-1725
Phone 262-256-3020
Mailing address
138 North Ave Ste 4Hartland, WI 53029-1725
Phone 262-256-3020
Authorized official
Jamie Kaminski
Owner, Nurse Practitioner
2622563020
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