LAKESHORES OUTPATIENT CLINIC

KENOSHA, WI
NPI1629111943
Doing Business AsBROTOLOC
Entity TypeOrganization
Authorized ContactMELANIE BARBEAUX-STINSON
Director
262-656-9975
Organization Subpart ?No
Primary Taxonomy261QM0801X 
(Licence: WI  2605)
Enumeration Date2007-02-15
Last Update Date2020-08-22
Business Address
LAKESHORES OUTPATIENT CLINIC
3917 47TH AVE
KENOSHA, WI 53144-1956
Phone number: 262-656-9975
Mailing Address
LAKESHORES OUTPATIENT CLINIC
3917 47TH AVE
KENOSHA, WI 53144-1956
Phone number: 262-656-9975