Organization
INTEGRATED WOUND CARE WISCONSIN MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE LUSAS (MEMBER)
(212) 734-6621
Entity
Organization
Contact information
Practice address
33 E MAIN ST STE 610, MADISON, WI 53703-4655
(212) 734-6621
Mailing address
492C CEDAR LN STE 514, TEANECK, NJ 07666-1713
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/21/2025
Last updated
06/15/2026
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