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1720351919
LAKE COUNTRY PRIVATE MEDICAL, S.C.
OCONOMOWOC, WI
NPI
1720351919
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Entity Type
Organization
Authorized Contact
PATRICK T FITZGERALD
Owner
262-567-5190
Organization Subpart ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: WI 48412)
Enumeration Date
2012-02-17
Last Update Date
2012-05-18
Business Address
LAKE COUNTRY PRIVATE MEDICAL, S.C.
1185 CORPORATE CENTER DR STE 300
OCONOMOWOC, WI 53066-4887
Phone number: 262-567-5190
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Mailing Address
LAKE COUNTRY PRIVATE MEDICAL, S.C.
1185 CORPORATE CENTER DR STE 300
OCONOMOWOC, WI 53066-4887
Phone number: 262-567-5190
Copy
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