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STATE MEDICAID

Preferred Provider Organization

NPI: 1891898219Organization

Specialties, Licenses & Credentials

Preferred Provider OrganizationPrimary

Preferred Provider Organization

Code: 305R00000X

Contact & Hours

Address
824 LOTHE ST
SUN PRAIRIE, WI 53590

Quick Facts

NPI
1891898219
Entity Type
Organization
Medicare
Not confirmed
Specialties
1
Locations
1

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