Provider First Line Business Practice Location Address:
GERMANTOWN HIGH SCHOOL W180 N11501 RIVER LANE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GERMANTOWN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-502-7254
Provider Business Practice Location Address Fax Number:
262-253-3494
Provider Enumeration Date:
07/02/2026