Great Lakes Medical LLC

NPI #1497980759 in Franklin, Wisconsin

Provider Information

NPI Number: 1497980759
Entity Type: Organization
Organization Name: Great Lakes Medical LLC
Subpart: Yes (part of a larger organization)
Parent Organization: GREAT LAKES FOOT & ANKLE CENTERS OF GREATER MILWAUKEE LLC
Primary Specialty: Clinic/Center - Ambulatory Surgical
Enumeration Date: May 15, 2009
Last Updated: Mar 15, 2011

Practice Location

Address: 8153 S 27TH ST
City: Franklin
State: Wisconsin
ZIP Code: 53132-7012
Phone: (773) 885-7696

Authorized Official

Name: DR. JOHN L BOSTANCHE, DPM
Title: DIRECTOR
Phone: (262) 657-3668

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Ambulatory Surgical — Ambulatory Surgical	261QA1903X	Primary

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