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Organization
SOUTHEAST WISCONSIN AMBULATORY SURGICAL CENTER S C
Active
Organization
SOUTHEAST WISCONSIN AMBULATORY SURGICAL CENTER S C
Active
Other names
SOUTHEAST WISCONSIN SURGICAL SUITES SC
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA R CERNAK DPM (OWNER)
(262) 697-4301
Entity
Organization
Contact information
Practice address
10105 74TH ST, SUITE 102, KENOSHA, WI 53142-7519
(262) 697-4301
(262) 925-8409
Mailing address
10105 74TH ST, SUITE 102, KENOSHA, WI 53142-7519
(262) 697-4301
(262) 925-8409
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
52D1008619
WI
Other
Enumeration date
03/21/2007
Last updated
07/07/2014
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