Organization
SPORTS MEDICINE & ORTHOPEDIC CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J PAUERS (EXECUTIVE DIRECTOR)
(414) 647-0033
Entity
Organization
Contact information
Practice address
2424 S 90TH ST, SUITE 418, WEST ALLIS, WI 53227-2455
(414) 328-7767
(414) 328-8127
Mailing address
3033 W LAYTON AVE, SUITE 102, GREENFIELD, WI 53221-2628
(414) 647-0033
(414) 647-0079
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32685200
—
WI
Enumeration date
12/20/2007
Last updated
12/03/2008
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