Provider First Line Business Practice Location Address:
1200 DEWEY AVE
Provider Second Line Business Practice Location Address:
AURORA PSYCHIATRIC HOSPITAL
Provider Business Practice Location Address City Name:
WAUWATOSA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-454-6754
Provider Business Practice Location Address Fax Number:
414-454-6789
Provider Enumeration Date:
07/09/2007