Organization
LAKESHORE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANK LAVORA DPM (PODIATRIST)
(414) 768-5430
Entity
Organization
Contact information
Practice address
3305 S 20TH ST, SUITE 100, MILWAUKEE, WI 53215-4940
(414) 645-1808
Mailing address
3305 S 20TH ST, SUITE 100, MILWAUKEE, WI 53215-4940
(414) 645-1808
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
178111-30
WI
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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