Organization
LAKE COUNTRY PLASTIC AND HAND SURGERY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY E MCCALL (SOLE OWNER)
(262) 523-1200
Entity
Organization
Contact information
Practice address
N19W24075 RIVERWOOD DR STE 228, WAUKESHA, WI 53188-1170
(262) 523-1200
Mailing address
N19W24075 RIVERWOOD DR STE 228, WAUKESHA, WI 53188-1170
(262) 523-1200
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
08/23/2006
Last updated
04/30/2019
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