Providence Family Medical Clinic S.c
NPI #1861857542 in Glendale, Wisconsin
Provider Information
- NPI Number
- 1861857542
- Entity Type
- Organization
- Organization Name
- Providence Family Medical Clinic S.c
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Dec 22, 2015
- Last Updated
- Dec 22, 2015
Practice Location
Authorized Official
- Name
- DR. ADEDAPO F OKUSANYA, M.D.
- Title
- PRESIDENT
- Phone
- (269) 598-7404
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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