PREMISE HEALTH OF WISCONSIN MEDICAL S C is a multi-specialty clinic center in Oshkosh, WI. PREMISE HEALTH OF WISCONSIN MEDICAL S C NPI is 1235890435. The provider is registered as an organization entity type. The provider Is Doing Business As Three Waves Health Clinic And Wellness Center.
The provider's business location address is:
292 OHIO ST OSHKOSH, WI ZIP 54902-825 Phone: (920) 267-5332 Fax: (855) 253-3142
The provider's authorized official is Jonathan Leizman . The authorized official title is President and has the following contact phone number (216) 479-9063.
The CLIA number assigned to this NPI record is 52D2089531 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 1/10/2022 and was last updated on 10/13/2022.
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:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 3/30/2025
NPI Synchronization or Removal
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