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Organization

LAKESHORE MEDICAL CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KARA RICHARDSON (ASST TREASURER)
(704) 631-0450
Entity
Organization

Contact information

Practice address
3611 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3708
(414) 762-7270
(414) 762-7864
Mailing address
3611 S CHICAGO AVE, SOUTH MILWAUKEE, WI 53172-3738
(414) 762-7270
(414) 762-7864

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
12/11/2006
Last updated
10/14/2025
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