Organization
PAIN CENTERS OF WISCONSIN - WAUWATOSA, LLC
Active
Parent organization
APM WISCONSIN MSO, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
APM WISCONSIN MSO, LLC
Authorized official
VISHAL LAL (AUTHORIZED REPRESENTATIVE)
(414) 325-7246
Entity
Organization
Contact information
Practice address
959 N MAYFAIR RD, WAUWATOSA, WI 53226-3465
(414) 325-7246
Mailing address
4131 W LOOMIS RD, SUITE 300, GREENFIELD, WI 53221-2057
(414) 325-7256
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/13/2015
Last updated
03/13/2015
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