Provider First Line Business Practice Location Address:
4560 SE INTERNATIONAL WAY
Provider Second Line Business Practice Location Address:
SUITE 100 CONSONUS HEALTHCARE SERVICES
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
97222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
971-206-5129
Provider Business Practice Location Address Fax Number:
971-206-5209
Provider Enumeration Date:
03/12/2007