GREAT LAKES SURGERY LLC

KENOSHA, WI
NPI1629518006
Entity TypeOrganization
Authorized ContactJOHN L BOSTANCHE
Director
262-657-0224
Organization Subpart ?No
Primary Taxonomy261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date2017-03-03
Last Update Date2017-03-03
Business Address
GREAT LAKES SURGERY LLC
6123 GREEN BAY RD STE 101
KENOSHA, WI 53142-2927
Phone number: 262-657-0224
Mailing Address
GREAT LAKES SURGERY LLC
6123 GREEN BAY RD SUITE 100
KENOSHA, WI 53142-2927
Phone number: 262-657-0224
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