GREAT LAKES FOOT & ANKLE CENTERS INC
Medical Practice at Green Bay Rd, Kenosha, WI

License number
Wisconsin 025
Category
Medical Practice
Type
Foot & Ankle Surgery
License number
Wisconsin 016
Category
Medical Practice
Type
Foot & Ankle Surgery
Owner
Name: MRS. LISA K THIERY
Title: BUSINESS MANAGER
Phone: (262) 657-3668
Address
Address
6123 Green Bay Rd SUITE 100, Kenosha, WI 53142
National Provider ID: 1295941409
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GREAT LAKES FOOT & ANKLE CENTERS INC

6123 Grn Bay Rd SUITE 100, Kenosha, WI 53142

Registration:
Feb 18, 1993
State ID:
G024525
Business type:
Domestic Business

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