Provider First Line Business Practice Location Address:
1126 S 70TH STREET SUITE S305B
Provider Second Line Business Practice Location Address:
WHEATON FRANCISCAN REHAB SERVICES
Provider Business Practice Location Address City Name:
WEST ALLIS
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-456-2336
Provider Business Practice Location Address Fax Number:
414-456-2339
Provider Enumeration Date:
05/21/2008