Individual
DR. MARY L. GANZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1290 BETSY ROSS CT, BROOKFIELD, WI 53045-5362
(262) 796-0203
Mailing address
1290 BETSY ROSS CT, BROOKFIELD, WI 53045-5362
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
29009
WI
Other
Enumeration date
07/23/2006
Last updated
03/14/2011
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