institution
Lake Country Foot & Ankle Sc
Foot & Ankle Surgery Podiatrist in Pewaukee, Wisconsin
NPI 1245590017

Lake Country Foot & Ankle Sc is a Foot & Ankle Surgery Podiatrist based in Pewaukee, WI and is specialized in Foot & Ankle Surgery. Lake Country Foot & Ankle Sc practices in Pewaukee, WI. The NPI Number for Lake Country Foot & Ankle Sc is 1245590017 and holds a License No. 794-025 (Wisconsin).

The current practice location address for Lake Country Foot & Ankle Sc is 1177 Quail Ct Ste 103, Pewaukee, WI and can be reached out via phone at 262-695-6440 and via fax at 262-695-2668.

Location: 1177 Quail Ct Ste 103, Pewaukee, WI, 53072-3768
institution
Provider Profile Details
NPI Number
1245590017
Provider Name
Lake Country Foot & Ankle Sc
Credential
Provider Entity Type
Organization
Address
1177 Quail Ct Ste 103, Pewaukee, WI, 53072-3768
Phone Number
262-695-6440
Fax Number
262-695-2668
Provider Enumeration Date
05/25/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000082018 01 WI P10
institution
Provider Business Practice Location Address Details
Address
1177 Quail Ct Ste 103
City
State
Zip
53072-3768
Phone Number
262-695-6440
Fax Number
262-695-2668
person
Provider Business Mailing Address Details
Address
1177 Quail Ct Ste 103
City
State
Zip
53072-3768
Phone Number
262-695-6440
Fax Number
262-695-2668
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
794-025 (Wisconsin)
Definition
Definition to come...
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