Provider First Line Business Practice Location Address:
3237 S. 16TH ST.
Provider Second Line Business Practice Location Address:
ST. FRANCIS HOSPITAL, 6TH FLOOR
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-647-5210
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2006