GREAT LAKES MEDICAL LLC

FRANKLIN, WI
NPI1497980759
Entity TypeOrganization
Authorized ContactJOHN L BOSTANCHE
Director
262-657-3668
Organization Subpart ?Yes
Primary Taxonomy261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date2009-05-15
Last Update Date2011-03-15
Business Address
GREAT LAKES MEDICAL LLC
8153 S 27TH ST
FRANKLIN, WI 53132-7012
Phone number: 773-885-7696
Mailing Address
GREAT LAKES MEDICAL LLC
DEPARTMENT 7917
CAROL STREAM, IL 60122
Phone number: 773-885-7696