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720 S Vanburen St Suite 101 Green Bay WI 54301-3534 | |
(920) 468-3444 | |
(920) 432-6313 |
Full Name | |
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Speciality | Clinic/center |
Location | 720 S Vanburen St, Green Bay, Wisconsin |
Authorized Official Name and Position | Denise K Stroobants (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 9204457226 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 22487 Green Bay WI 54305-2487 Ph: (920) 445-7210 | 720 S Vanburen St Suite 101 Green Bay WI 54301-3534 Ph: (920) 468-3444 |
NPI Number | 1497191951 |
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Provider Enumeration Date | 05/10/2013 |
Last Update Date | 01/06/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497191951 | NPI | - | NPPES |
52D0394921 | Other | WI | CLIA # |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
3d Brows And Wellness Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 Hoffman Rd Ste 106, Green Bay, WI 54301 Phone: 920-277-6989 | |