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Organization
MILWAUKEE CLINIC OF ORTHO SURGERY, LTD.
Active
Organization
MILWAUKEE CLINIC OF ORTHO SURGERY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY J. BANACH (ADMINISTRATOR)
(414) 321-8960
Entity
Organization
Contact information
Practice address
7400 W RAWSON AVE, SUITE 125, FRANKLIN, WI 53132-8278
(414) 321-8960
(414) 321-0632
Mailing address
7400 W RAWSON AVE, SUITE 125, FRANKLIN, WI 53132-8278
(414) 321-8960
(414) 321-0632
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
—
WI
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32738000
—
WI
Enumeration date
05/18/2006
Last updated
02/06/2014
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