Premise Health of Connecticut Medical, P.c.

NPI #1326202367 in South Milwaukee, Wisconsin

Provider Information

NPI Number: 1326202367
Entity Type: Organization
Organization Name: Premise Health of Connecticut Medical, P.c.
Primary Specialty: Contractor
Enumeration Date: Jul 17, 2008
Last Updated: Aug 15, 2022

Practice Location

Address: 1100 MILWAUKEE AVE
City: South Milwaukee
State: Wisconsin
ZIP Code: 53172-2013
Phone: (414) 768-4444

Authorized Official

Name: JON LEIZMAN
Title: PRESIDENT
Phone: (216) 479-9063

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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