| Liberty Star Medical Ltd | |
|
1905 Center Ave Suite 5 Janesville WI 53546-2842 | |
| (608) 563-4213 | |
| (866) 998-1030 |
| Full Name | Liberty Star Medical Ltd |
|---|---|
| Speciality | Clinic/center |
| Location | 1905 Center Ave, Janesville, Wisconsin |
| Authorized Official Name and Position | David Brian Gattuso (PHYSICIAN) |
| Authorized Official Contact | 6085634213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Star Medical Ltd 1905 Center Ave Suite 5 Janesville WI 53546-2842 Ph: (608) 295-3670 | Liberty Star Medical Ltd 1905 Center Ave Suite 5 Janesville WI 53546-2842 Ph: (608) 563-4213 |
| NPI Number | 1184973877 |
|---|---|
| Provider Enumeration Date | 09/10/2012 |
| Last Update Date | 09/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184973877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 27454-20 (Wisconsin) | Primary |
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