# DIABETES OSTEOPOROSIS THYROID ENDOCRINE CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679735997
- **Authorized official:** MS. JULIE HARDY (OFFICE MANAGER)
- **Authorized official phone:** (262) 619-3473

## Contact information

- **Practice address:** 1532 S GREEN BAY RD STE 300, MOUNT PLEASANT, WI 53406-4410
- **Practice address phone:** (262) 619-3473
- **Practice address fax:** (262) 619-3473
- **Mailing address:** 4077 LIGHTHOUSE DR, RACINE, WI 53402-3113
- **Mailing address phone:** (262) 619-3473
- **Mailing address fax:** (262) 619-9600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 41940020 | WI | Yes |

## Other

- **Enumeration date:** 06/27/2008
- **Last updated:** 01/02/2015