Graduated: 2013
NPI: 1669891164
Practice Locations (2)
LAKESHORE MEDICAL CLINIC LLC
200 E RYAN RD
OAK CREEK, WI 531544563
4145703590
LAKESHORE MEDICAL CLINIC LLC
2000 E LAYTON AVE
SAINT FRANCIS, WI 532356053
4147446589
Source: CMS National Downloadable File, September 2026.