Liberty Star Medical Ltd

NPI #1184973877 in Janesville, Wisconsin

Provider Information

NPI Number: 1184973877
Entity Type: Organization
Organization Name: Liberty Star Medical Ltd
Primary Specialty: Clinic/Center
Enumeration Date: Sep 10, 2012
Last Updated: Sep 20, 2012

Practice Location

Address: 1905 CENTER AVE
Address 2: SUITE 5
City: Janesville
State: Wisconsin
ZIP Code: 53546-2842
Phone: (608) 563-4213

Authorized Official

Name: DR. DAVID BRIAN GATTUSO SR., MD
Title: PHYSICIAN
Phone: (608) 563-4213

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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