Healthcare Provider Details

I. General information

NPI: 1508292574
Provider Name (Legal Business Name): MIDWIFERY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2013
Last Update Date: 09/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 9TH AVE W
ASHLAND WI
54806-2808
US

IV. Provider business mailing address

619 9TH AVE W
ASHLAND WI
54806-2808
US

V. Phone/Fax

Practice location:
  • Phone: 715-292-6367
  • Fax: 715-292-6367
Mailing address:
  • Phone: 715-292-6367
  • Fax: 715-292-6367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number11-049
License Number StateWI

VIII. Authorized Official

Name: SAVITA LOMIRA JONES
Title or Position: OWNER/MANAGER
Credential: LM
Phone: 715-413-0197