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301 E Saint Joseph St Green Bay WI 54301-2241 | |
(920) 433-3630 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 301 E Saint Joseph St, Green Bay, Wisconsin |
Authorized Official Name and Position | Denise K Stroobants (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 9204457222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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301 E Saint Joseph St Green Bay WI 54301-2241 Ph: (920) 433-3630 | 301 E Saint Joseph St Green Bay WI 54301-2241 Ph: (920) 433-3630 |
NPI Number | 1457677338 |
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Provider Enumeration Date | 04/16/2010 |
Last Update Date | 04/16/2010 |
Identifier | Type | State | Issuer |
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1457677338 | NPI | - | NPPES |
10065921 | Other | WI | WI MA PAYOR ID - AODA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 1098 (Wisconsin) | 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 | |