Provider First Line Business Practice Location Address:
MCW CAMPUS CLINIC SOUTH
Provider Second Line Business Practice Location Address:
1231 WEST MITCHELL STREET
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-643-8461
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2006