GREAT LAKES DERMATOLOGY

RACINE, WI
NPI1689757569
Entity TypeOrganization
Authorized ContactCATHY J DEAN
Administrator
800-485-8640
Organization Subpart ?No
Primary Taxonomy207NS0135X Dermatology, Procedural Dermatology
Enumeration Date2006-10-23
Last Update Date2020-08-22
Business Address
GREAT LAKES DERMATOLOGY
1515 S GREENBAY RD
RACINE, WI 53406-4409
Phone number: 262-632-2074
Mailing Address
GREAT LAKES DERMATOLOGY
1515 S GREENBAY RD
RACINE, WI 53406-4409
Phone number: 262-632-2074
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