Provider First Line Business Practice Location Address:
8700 W WATERTOWN PLANK RD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PLASTIC SURGERY
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226-3595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-805-5440
Provider Business Practice Location Address Fax Number:
414-259-0901
Provider Enumeration Date:
07/23/2006