Organization · Type 2 NPI
Premise Health of Wisconsin Medical SC
Multi-Specialty Clinic/Center · Kenosha, WI
NPI number
1760109052
Active
Practice location
4303 39th Ave
Kenosha, WI 53144-1969
Mailing address
5500 Maryland Way Ste 120
Brentwood, TN 37027-4993
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Multi-Specialty Clinic/Center Primary | 261QM1300X | None listed |
Multi-Specialty Clinic/Center: Definition to come...
2 other providers at this address
About NPI 1760109052
Premise Health of Wisconsin Medical SC's National Provider Identifier is 1760109052, issued on Oct 26, 2022. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Kenosha, WI. The record was last updated on Feb 17, 2026.