Lakeside Neurocare Limited.

NPI 1225220254 - Psychiatry & Neurology - 2084N0400X

NPI Details
NPI 1225220254
Enumeration Date 08/14/2007
Last Updated 04/13/2012
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name SUSAN M SUSAN
Position BUSINESS MANAGER
Phone (920) 923-5526
Fax (920) 923-5871
Practice Location
430 E DIVISION ST
FOND DU LAC WI, 54935-4560, US
Phone (920) 923-5526
Fax (920) 923-5871
Business Location
2700 W 9TH AVE STE 225
OSHKOSH WI, 54904-7865, US
Phone (920) 223-5580
Fax (920) 223-5592
Toxanomy
Taxonomy Code 2084N0400X
License State
License Number
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According to our database, Lakeside Neurocare Limited. NPI is 1225220254, taxonomy code is 2084N0400X Lakeside Neurocare Limited. physically located at 430 E Division St, Fond Du Lac WI, 54935-4560. NPI Number 1033115704 has the healthcare provider type.

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1225220254 NPI number is provided on an as is basis without warranty of any kind. 1225220254 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeside Neurocare Limited. are for informational purposes only.