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Organization
LAKESHORE PAIN AND SPINE CENTER LLC
Active
Organization
LAKESHORE PAIN AND SPINE CENTER LLC
Active
Other names
LAKESHORE PAIN AND SPINE CENTER LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY SILVA MD (OWNER/MD)
(262) 484-4035
Entity
Organization
Contact information
Practice address
7201 GREEN BAY RD, KENOSHA, WI 53142-3532
(312) 519-9936
Mailing address
7201 GREEN BAY RD, KENOSHA, WI 53142-3532
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
04/21/2021
Last updated
08/02/2021
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