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General NPI Number Information
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NPI Number | 1083571897
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Entity Type | Organization
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Legal Business Name | HOPE MEDICAL LLC
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 10345 COUNTY ROAD ID
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City | BLUE MOUNDS
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State | WI
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Zip | 53517-9646
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Country | US
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Telephone | 320-309-9471
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Fax |
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Provider Business Mailing Address
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Address Line | 10345 COUNTY ROAD ID
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City | BLUE MOUNDS
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State | WI
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Zip | 53517-9646
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | SAMANTHA LEASE
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Credential | DO
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Telephone | 320-309-9471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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