GREAT LAKES FAMILY MEDICAL CENTER INC

KENOSHA, WI
NPI1093900136
Entity TypeOrganization
Authorized ContactJAWAID QUDDUS
President
262-764-4390
Organization Subpart ?No
Primary Taxonomy261Q00000X Clinic/Center
(Licence: WI  45606020)
Enumeration Date2007-09-12
Last Update Date2010-08-26
Business Address
GREAT LAKES FAMILY MEDICAL CENTER INC
6123 GREEN BAY RD SUITE 120
KENOSHA, WI 53142-2927
Phone number: 262-764-4390
Mailing Address
GREAT LAKES FAMILY MEDICAL CENTER INC
6123 GREEN BAY ROAD SUITE 120
KENOSHA, WI 53142-2927
Phone number: 262-764-4390
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