Provider First Line Business Practice Location Address:
GATEWAY HEALTH CENTER
Provider Second Line Business Practice Location Address:
801 S. 70TH ST,
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:
414-773-6631
Provider Business Practice Location Address Fax Number:
414-773-6635
Provider Enumeration Date:
05/18/2006