Provider First Line Business Practice Location Address:
8700 W WATERTOWN PLANK RD
Provider Second Line Business Practice Location Address:
SPORTS MEDICINE
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226-3595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-805-7100
Provider Business Practice Location Address Fax Number:
414-805-7171
Provider Enumeration Date:
08/13/2013