SOUTHEAST WISCONSIN AMBULATORY SURGICAL CENTER S C NPI 1225153620

NPI Information

SOUTHEAST WISCONSIN AMBULATORY SURGICAL CENTER S C is an ambulatory surgical clinic center in Kenosha, WI. SOUTHEAST WISCONSIN AMBULATORY SURGICAL CENTER S C NPI is 1225153620. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Southeast Wisconsin Surgical Suites Sc.

The provider's business location address is:

10105 74TH ST
SUITE 102
KENOSHA, WI
ZIP 53142-519
Phone: (262) 697-4301
Fax: (262) 925-8409

The provider's authorized official is Cynthia R Cernak .
The authorized official title is Owner and has the following contact phone number (262) 697-4301.

The enumeration date for this NPI number is 3/21/2007 and was last updated on 7/7/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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