Lakeshore Medical Clinic

NPI #1205240686 in Milwaukee, Wisconsin

Provider Information

NPI Number
1205240686
Entity Type
Organization
Organization Name
Lakeshore Medical Clinic
Primary Specialty
Nurse Practitioner - Family
Enumeration Date
Jun 13, 2014
Last Updated
Jun 13, 2014

Practice Location

Address
3305 S 20TH ST
Address 2
SUITE 100
ZIP Code
53215-4940
Phone
(414) 645-1808

Authorized Official

Name
FRANK LAVORA, DPM
Title
PODIATRIST
Phone
(414) 768-5430

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner - FamilyFamily

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