Organization
ADVANCED LIPIDOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TARA DALL M.D. (OWNER)
(262) 646-3223
Entity
Organization
Contact information
Practice address
524 MILWAUKEE ST, SUITE 180, DELAFIELD, WI 53018-1460
(262) 646-3223
(262) 646-3443
Mailing address
524 MILWAUKEE ST, SUITE 180, DELAFIELD, WI 53018-1460
(262) 646-3223
(262) 646-3443
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41339
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32610400
—
WI
Enumeration date
06/11/2008
Last updated
06/11/2008
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