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Individual

LAWRENCE C SANDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
6308 8TH AVE, KENOSHA, WI 53143-5031
(262) 656-3290
Mailing address
2123 RAMADA DR, RACINE, WI 53406-2220
(262) 886-0463

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
2065-024
WI

Other

Enumeration date
01/31/2007
Last updated
07/08/2007
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