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Organization

SOUTHERN LAKES ENDOSCOPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY JO BURNS (DIRECTOR REVENUE CYCLE MANAGEMENT)
(262) 970-7825
Entity
Organization

Contact information

Practice address
240 MAPLE AVE STE 2220, MUKWONAGO, WI 53149-8475
(414) 454-0600
(414) 454-0971
Mailing address
2801 W KINNICKINNIC RIVER PKWY STE 1080, MILWAUKEE, WI 53215-3689
(414) 908-6615
(414) 908-6634

Taxonomy

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

Other

Enumeration date
07/03/2018
Last updated
03/19/2026
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