Organization
NWSC WI DR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAIL ODEN CASC, MBA (ADMINISTRATOR)
(414) 257-3322
Entity
Organization
Contact information
Practice address
1233 N MAYFAIR RD STE 304, MILWAUKEE, WI 53226-3255
(414) 257-3322
(414) 257-3364
Mailing address
1233 N MAYFAIR RD STE 304, MILWAUKEE, WI 53226-3255
(414) 257-3322
(414) 257-3364
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
—
—
Other
Enumeration date
06/27/2019
Last updated
06/27/2019
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