Organization
MILWAUKEE ASC LLC
Active
Other names
Milwaukee Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP A CLENDENIN (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
8585 W FOREST HOME AVE, GREENFIELD, WI 53228-3417
(414) 427-5138
(414) 427-5145
Mailing address
8585 W FOREST HOME AVE, GREENFIELD, WI 53228-3417
(414) 427-5138
(414) 427-5145
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
NONE REQUIRED
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41909300
—
WI
Enumeration date
02/02/2006
Last updated
09/07/2023
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