Provider First Line Business Practice Location Address:
COLUMBIA ST. MARY'S HOSPITAL, DIABETES TREATMENT CTR
Provider Second Line Business Practice Location Address:
2025 E NEWPORT AVE
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-961-4641
Provider Business Practice Location Address Fax Number:
414-961-4435
Provider Enumeration Date:
03/26/2007