Organization
SPORTS MEDICINE & ORTHOPEDIC CENTER, S.C.
Active
Organization
SPORTS MEDICINE & ORTHOPEDIC CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER B BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5954
Entity
Organization
Contact information
Practice address
3033 W LAYTON AVE, SUITE 102, GREENFIELD, WI 53221-2628
(414) 647-0033
(414) 647-0079
Mailing address
3033 W LAYTON AVE STE 102, GREENFIELD, WI 53221-2628
(414) 647-0033
(414) 647-0079
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32685200
—
WI
Enumeration date
10/14/2005
Last updated
09/12/2025
Update your record
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