Graduated: 2023
NPI: 1366261661
Practice Locations (2)
LAKESHORE MEDICAL CLINIC LLC
200 E RYAN RD
OAK CREEK, WI 531544563
4145703590
AURORA ADVANCED HEALTHCARE, INC.
1475 W GRAND AVE
PORT WASHINGTON, WI 530742074
2622685100
Source: CMS National Downloadable File, September 2026.