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General NPI Number Information
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NPI Number | 1114495769
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Entity Type | Organization
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Legal Business Name | MONONA BAY HEALTH LLC
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Dates
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Enumeration Date | 11/12/2018
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 18 SOUTH BEDFORD ST SUITE 418
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City | MADISON
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State | WI
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Zip | 53703
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Country | US
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Telephone | 608-571-4376
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Fax |
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Provider Business Mailing Address
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Address Line | 910 LAKE CT
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City | MADISON
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State | WI
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Zip | 53715-2018
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Country | US
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Telephone | 608-571-4376
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GABRIEL M KARTER
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Credential | LAC, MSTOM
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Telephone | 608-571-4376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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