PREMISE HEALTH OF WISCONSIN MEDICAL S.C. NPI 1154074326

NPI Information

PREMISE HEALTH OF WISCONSIN MEDICAL, S.C. is a multi-specialty clinic center in Madison, WI. PREMISE HEALTH OF WISCONSIN MEDICAL, S.C. NPI is 1154074326. The provider is registered as an organization entity type.
The provider Is Doing Business As True Stage Madison.

The provider's business location address is:

5910 MINERAL POINT RD
MADISON, WI
ZIP 53705-456
Phone: (608) 665-4990

The provider's authorized official is Jonathan Leizman .
The authorized official title is President and has the following contact phone number (615) 468-6270.

The CLIA number assigned to this NPI record is 52D2112696 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2022 and was last updated on 7/18/2023.

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:

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