Lakeshore Medical Clinic, LLC
NPI #1962607366 in New Berlin, Wisconsin
Provider Information
- NPI Number
- 1962607366
- Entity Type
- Organization
- Organization Name
- Lakeshore Medical Clinic, LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Enumeration Date
- Jun 18, 2007
- Last Updated
- Jul 20, 2017
Practice Location
- Address
- 14555 W NATIONAL AVE
- Address 2
- STE 165
- City
- New Berlin
- State
- Wisconsin
- ZIP Code
- 53151-4494
- Phone
- (262) 827-2959
Authorized Official
- Name
- MICHAEL BANIA
- Title
- SENIOR DIRECTOR
- Phone
- (414) 766-9094
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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