Individual
LAWRENCE A GILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
(262) 334-3451
Mailing address
1700 W PARADISE DR, WEST BEND, WI 53095-9795
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21252
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1008
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/20/2006
Last updated
07/18/2012
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