Provider First Line Business Practice Location Address:
5433 W FOND DU LAC AVE
Provider Second Line Business Practice Location Address:
MIDTOWN PEDIATRICS
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53216-1382
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-277-8915
Provider Business Practice Location Address Fax Number:
414-277-8983
Provider Enumeration Date:
05/17/2006