Genovacare-Wisconsin, LLC
NPI #1578860292 in Greenfield, Wisconsin
Provider Information
- NPI Number
- 1578860292
- Entity Type
- Organization
- Organization Name
- Genovacare-Wisconsin, LLC
- Primary Specialty
- Clinic/Center - Rehabilitation
- Enumeration Date
- Feb 15, 2011
- Last Updated
- Feb 15, 2011
Practice Location
- Address
- 8575 W FOREST HOME AVE STE 50
- City
- Greenfield
- State
- Wisconsin
- ZIP Code
- 53228-3469
- Phone
- (414) 525-9999
Authorized Official
- Name
- THOMAS MARTIN TOMERLIN
- Title
- MANAGER
- Phone
- (210) 564-0100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rehabilitation — Rehabilitation |
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