Organization
MILWAUKEE CLINIC OF ORTHO SURGERY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY J. BANACH (ADMINISTRATOR)
(414) 321-8960
Entity
Organization
Contact information
Practice address
7400 W RAWSON AVE, SUITE 125, FRANKLIN, WI 53132-8278
(414) 321-8960
(414) 321-0632
Mailing address
7400 W RAWSON AVE, SUITE 125, FRANKLIN, WI 53132-8278
(414) 321-8960
(414) 321-0632
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
WI
213ES0103X
Foot & Ankle Surgery Podiatrist
—
WI
332B00000X
Durable Medical Equipment & Medical Supplies
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32738000
—
WI
Enumeration date
05/18/2006
Last updated
02/06/2014
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