Organization · Type 2 NPI

Great Lakes Foot & Ankle Centers Inc

Foot & Ankle Surgery Podiatrist · Kenosha, WI

NPI number 1295941409 Active

Practice location

6123 Green Bay Rd, Suite 100
Kenosha, WI 53142-2927

Fax (262) 652-0564

Specialties and licenses

TaxonomyCodeLicense
Foot & Ankle Surgery Podiatrist 213ES0103X016 (IL)
Foot & Ankle Surgery Podiatrist Primary 213ES0103X025 (WI)

Foot & Ankle Surgery Podiatrist: Definition to come...

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About NPI 1295941409

Great Lakes Foot & Ankle Centers Inc's National Provider Identifier is 1295941409, issued on May 15, 2007. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Kenosha, WI. The record was last updated on Sep 20, 2021.