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Sports Medicine

West Allis, Wisconsin

Provider NPI: 1194715995

Provider Information:

Practice Location:
2424 S 90TH ST SUITE 500 WEST ALLIS, WI 53227 US
Tel: 414-328-8600  Fax: --

Business Mailing Address:
Tel: --  Fax: --


PrimaryCodeCategory/DescriptionStateLicense Number
Orthopaedic Surgery
Sports Medicine

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin

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