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Organization

NORTHWEST SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GAIL JOYCE ODEN CASC. MBA (ADMINISTRATOR)
(414) 257-3322
Entity
Organization

Contact information

Practice address
13402 W COAL MINE AVE, 310, LITTLETON, CO 80127-5407
(414) 257-3322
Mailing address
1233 N MAYFAIR RD STE 304, WAUWATOSA, WI 53226-3255
(414) 257-3322

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
02/21/2017
Last updated
02/21/2017
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