Provider First Line Business Practice Location Address:
111 WEST MICHIGAN ST
Provider Second Line Business Practice Location Address:
PROSTEP/EXTENDICARE HEALTHSERVICES
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-908-8781
Provider Business Practice Location Address Fax Number:
414-918-2573
Provider Enumeration Date:
09/06/2007