Lakeshore Medical Clinic
NPI #1861754244 in Greenfield, Wisconsin
Provider Information
- NPI Number
- 1861754244
- Entity Type
- Organization
- Organization Name
- Lakeshore Medical Clinic
- Primary Specialty
- Clinic/Center - Physical Therapy
- Enumeration Date
- Jun 12, 2012
- Last Updated
- Jun 12, 2012
Practice Location
- Address
- 4444 WEST LOOMIS ROAD
- Address 2
- 200
- City
- Greenfield
- State
- Wisconsin
- ZIP Code
- 53220
- Phone
- (414) 281-5150
Authorized Official
- Name
- MASOOD WASIULLAH, MD
- Title
- PRESIDENT
- Phone
- (414) 525-2433
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
| Clinic/Center - Occupational Medicine — Occupational Medicine |
| Clinic/Center - Physical Therapy — Physical Therapy |
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