Organization
LAKE COUNTRY FOOT & ANKLE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY M FOSTER (OFFICE MANAGER)
(262) 695-6440
Entity
Organization
Contact information
Practice address
1177 QUAIL CT STE 103, PEWAUKEE, WI 53072-3768
(262) 695-6440
(262) 695-2668
Mailing address
1177 QUAIL CT STE 103, PEWAUKEE, WI 53072-3768
(262) 695-6440
(262) 695-2668
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
794025
WI
Other
Enumeration date
10/26/2006
Last updated
08/13/2008
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