Provider First Line Business Practice Location Address:
9200 W WISCONSIN AVE
Provider Second Line Business Practice Location Address:
FROEDTERT & MEDICAL COLLEGE PRE-OP CLINIC
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226-3522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-805-6250
Provider Business Practice Location Address Fax Number:
414-805-7210
Provider Enumeration Date:
07/20/2012