Brotoloc Inc. Outpatient Clinic
NPI #1184841660 in Whitewater, Wisconsin
Provider Information
- NPI Number
- 1184841660
- Entity Type
- Organization
- Organization Name
- Brotoloc Inc. Outpatient Clinic
- Primary Specialty
- Psychologist - Clinical
- Enumeration Date
- Apr 19, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 209 S TAFT ST
- City
- Whitewater
- State
- Wisconsin
- ZIP Code
- 53190-2139
- Phone
- (262) 473-0480
Authorized Official
- Name
- GARY S JOHNSON
- Title
- VICE PRESIDENT
- Phone
- (262) 473-0480
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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