Provider First Line Business Practice Location Address:
2564 N 124TH ST # 412
Provider Second Line Business Practice Location Address:
PRUDENT DIAGNOSTICS LABORATORIES
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226-1050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-949-1355
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/01/2013