Provider First Line Business Practice Location Address:
2301 N LAKE DRIVE ASCENSION COLUMBIA ST MARYS HOSPITAL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-447-3556
Provider Business Practice Location Address Fax Number:
414-462-5921
Provider Enumeration Date:
05/14/2025