Lakeshore Neurology | |
333 Reed Ave Manitowoc WI 54220-2087 | |
(920) 684-8895 | |
(920) 684-1384 |
Full Name | Lakeshore Neurology |
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Speciality | Psychiatry & Neurology - Neurology |
Location | 333 Reed Ave, Manitowoc, Wisconsin |
Authorized Official Name and Position | Mark Herzog (CEO) |
Authorized Official Contact | 9203202300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lakeshore Neurology 333 Reed Ave Po Box 963 Manitowoc WI 54220-2087 Ph: (920) 684-8895 | Lakeshore Neurology 333 Reed Ave Manitowoc WI 54220-2087 Ph: (920) 684-8895 |
NPI Number | 1457580862 |
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Provider Enumeration Date | 07/07/2009 |
Last Update Date | 07/07/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457580862 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 24465 (Wisconsin) | Primary |
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