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1497980759
GREAT LAKES MEDICAL LLC
FRANKLIN, WI
NPI
1497980759
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Entity Type
Organization
Authorized Contact
JOHN L BOSTANCHE
Director
262-657-3668
Organization Subpart ?
Yes
Primary Taxonomy
261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date
2009-05-15
Last Update Date
2011-03-15
Business Address
GREAT LAKES MEDICAL LLC
8153 S 27TH ST
FRANKLIN, WI 53132-7012
Phone number: 773-885-7696
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Mailing Address
GREAT LAKES MEDICAL LLC
DEPARTMENT 7917
CAROL STREAM, IL 60122
Phone number: 773-885-7696
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