Reliv of Southern Wisconsin
NPI #1629217062 in Beaver Dam, Wisconsin
Provider Information
- NPI Number
- 1629217062
- Entity Type
- Organization
- Organization Name
- Reliv of Southern Wisconsin
- Primary Specialty
- Home Health
- Enumeration Date
- Feb 9, 2009
- Last Updated
- Feb 10, 2009
Practice Location
- Address
- 201 PRAIRIE VIEW DR
- City
- Beaver Dam
- State
- Wisconsin
- ZIP Code
- 53916-3406
- Phone
- (920) 356-0681
Authorized Official
- Name
- MR. VITTORIO GIUSEPPE SPADARO SR.
- Title
- CHAIRMAN VP NUTRITION
- Phone
- (920) 356-0681
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
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