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1976 Lime Kiln Rd Green Bay WI 54311-4417 | |
(920) 406-9865 | |
(920) 406-9867 |
Full Name | |
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Speciality | Family Medicine |
Location | 1976 Lime Kiln Rd, Green Bay, Wisconsin |
Authorized Official Name and Position | Denise K Stroobants (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 9204337864 |
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) 445-7222 | 1976 Lime Kiln Rd Green Bay WI 54311-4417 Ph: (920) 406-9865 |
NPI Number | 1346293941 |
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Provider Enumeration Date | 05/18/2006 |
Last Update Date | 10/18/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346293941 | NPI | - | NPPES |
1033172390 | Medicaid | WI | |
52D1054543 | Other | WI | CLIA WAIVER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (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 | |