# LAKESHORE PAIN AND SPINE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LAKESHORE PAIN AND SPINE CENTER LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689256539
- **Authorized official:** DR. BRADLEY SILVA MD (OWNER/MD)
- **Authorized official phone:** (262) 484-4035

## Contact information

- **Practice address:** 7201 GREEN BAY RD, KENOSHA, WI 53142-3532
- **Practice address phone:** (312) 519-9936
- **Mailing address:** 7201 GREEN BAY RD, KENOSHA, WI 53142-3532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/21/2021
- **Last updated:** 08/02/2021