Provider First Line Business Practice Location Address:
8701 WATERTOWN PLANK ROAD
Provider Second Line Business Practice Location Address:
MEDICAL COLLEGE OF WISCONSIN DEPT OF PSYCHIATRY
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-955-8950
Provider Business Practice Location Address Fax Number:
414-955-6295
Provider Enumeration Date:
05/17/2006