Provider First Line Business Practice Location Address:
N57W24950 N CORPORATE CIR
Provider Second Line Business Practice Location Address:
PROHEALTH CARE MEDICAL ASSOCIATES INC.
Provider Business Practice Location Address City Name:
SUSSEX
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53089-4383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-820-3093
Provider Business Practice Location Address Fax Number:
262-532-9598
Provider Enumeration Date:
03/29/2012