Lake Country Endoscopy Center, LLC
NPI #1184897472 in Oconomowoc, Wisconsin
Provider Information
- NPI Number
- 1184897472
- Entity Type
- Organization
- Organization Name
- Lake Country Endoscopy Center, LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Apr 8, 2008
- Last Updated
- Jan 8, 2025
Practice Location
- Address
- 1185 CORPORATE CENTER DR
- Address 2
- SUITE 125
- City
- Oconomowoc
- State
- Wisconsin
- ZIP Code
- 53066-4845
- Phone
- (414) 454-0600
Authorized Official
- Name
- BAO XIONG THAO
- Title
- AUTHORIZED OFFICIAL
- Phone
- (414) 908-6506
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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