THE REDI CLINIC OF WAUWATOSA SC NPI 1043228505

NPI Information

THE REDI CLINIC OF WAUWATOSA, SC is a mental health (including community mental health center) clinic center in Wauwatosa, WI. THE REDI CLINIC OF WAUWATOSA, SC NPI is 1043228505. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Pathway Clinic, Sc.

The provider's business location address is:

2500 N. MAYFAIR RD, STE 600
WAUWATOSA, WI
ZIP 53226
Phone: (414) 727-4455
Fax: (414) 727-4690

The provider's authorized official is Theodore Weltzin .
The authorized official title is Co-owner and has the following contact phone number (414) 727-4455.

The enumeration date for this NPI number is 8/3/2006 and was last updated on 4/18/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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