Paddock Lake Family Practice, Sc

NPI #1417919275 in Salem, Wisconsin

Provider Information

NPI Number: 1417919275
Entity Type: Organization
Organization Name: Paddock Lake Family Practice, Sc
Primary Specialty: Family Medicine
Enumeration Date: Apr 5, 2006
Last Updated: Apr 20, 2008

Practice Location

Address: 7137 236TH AVE
Address 2: SUITE 103
City: Salem
State: Wisconsin
ZIP Code: 53168-9664
Phone: (262) 843-4422

Authorized Official

Name: MS. LISA M THOMAS
Title: BILLING MANAGER
Phone: (262) 843-2394

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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