Organization

Liberty Star Medical Ltd

Clinic/Center in Janesville, WI(View on Map)

Legal Business Name

Liberty Star Medical Ltd

NPI Number

1184973877

NPI Type

Organization

Enumeration Date

09/10/2012

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Licenses

State

Wisconsin

License Number

27454-20

Contact
Information

Purpose

Mailing
Location

Address

1905 CENTER AVE
1905 CENTER AVE

City

Janesville
Janesville

State

WI
WI

Postal Code

53546-2842
53546-2842

Country

US
US

Telephone Number

(608) 295-3670
(608) 563-4213

Authorized Official

Name

Dr. David Gattuso

Title or Position

PHYSICIAN

Telephone Number

(608) 563-4213

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/20/2012

Provider Address

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