Organization
PAIN CENTERS OF WISCONSIN - SAUK PRAIRIE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VISHAL LAL (CEO)
(414) 325-7246
Entity
Organization
Contact information
Practice address
250 26TH ST, SUITE 140, PRAIRIE DU SAC, WI 53578-2204
(414) 325-7246
(414) 325-3770
Mailing address
4131 W LOOMIS RD, SUITE 300, GREENFIELD, WI 53221-2057
(414) 325-7246
(414) 325-3770
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/14/2014
Last updated
10/24/2016
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