Organization · NPI-2

Caine INC

Family Medicine · Waukesha, WI

NPI number1356776215
StatusActive
Last updated in NPPESSep 11, 2013

Details

NPI
1356776215
Entity type
Organization (NPI-2)
Legal business name
Caine INC
Organization subpart
No
Enumeration date
Sep 11, 2013
Last updated
Sep 11, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine34605WIYes

Practice location

620 Bell St
Waukesha, WI 53186-5172

Phone 414-313-4652

Mailing address

11114 W Mequanigo Dr
West Allis, WI 53227-3051

Authorized official

Glenn Caine
President
4143134652

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