Provider First Line Business Practice Location Address:
414 W MORELAND BLVD
Provider Second Line Business Practice Location Address:
SUITE #205 FAMILY SERVICE OF WAUKESHA
Provider Business Practice Location Address City Name:
WAUKESHA
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-547-5567
Provider Business Practice Location Address Fax Number:
262-547-1608
Provider Enumeration Date:
10/10/2006