Antigo Medical Building, LLC

NPI #1396575353 in Antigo, Wisconsin

Provider Information

NPI Number: 1396575353
Entity Type: Organization
Organization Name: Antigo Medical Building, LLC
Primary Specialty: Family Medicine
Enumeration Date: Aug 5, 2024
Last Updated: Aug 5, 2024

Practice Location

Address: 1111 LANGLADE RD
City: Antigo
State: Wisconsin
ZIP Code: 54409-2787
Phone: (715) 623-3761

Authorized Official

Name: MICHELLE UNDEEN
Title: CREDENTIALING SPECIALIST
Phone: (239) 427-1257

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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