Pain Centers of Wisconsin - Beaver Dam, LLC
NPI #1437419561 in Beaver Dam, Wisconsin
Provider Information
- NPI Number
- 1437419561
- Entity Type
- Organization
- Organization Name
- Pain Centers of Wisconsin - Beaver Dam, LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- May 23, 2012
- Last Updated
- Oct 24, 2016
Practice Location
- Address
- 1701 N SPRING ST
- City
- Beaver Dam
- State
- Wisconsin
- ZIP Code
- 53916-1178
- Phone
- (414) 325-7246
Authorized Official
- Name
- VISHAL LAL
- Title
- CEO
- Phone
- (414) 325-7246
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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