Organization
AURORA MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY BAILET (PRESIDENT)
(414) 647-6322
Entity
Organization
Contact information
Practice address
110 BUTLER ST, RANDOM LAKE, WI 53075-1708
(920) 994-9094
Mailing address
110 BUTLER ST, RANDOM LAKE, WI 53075-1708
(920) 994-9094
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/18/2007
Last updated
02/19/2008
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