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2710 Executive Dr Green Bay WI 54304-5496 | |
(920) 496-4700 | |
(920) 496-4705 |
Full Name | |
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Speciality | Family Medicine |
Location | 2710 Executive Dr, Green Bay, Wisconsin |
Authorized Official Name and Position | Richard Rolston (PRESIDENT AND CEO) |
Authorized Official Contact | 9204964700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 19070 Prevea Health Regional Green Bay WI 54307-9070 Ph: (920) 496-4700 | 2710 Executive Dr Green Bay WI 54304-5496 Ph: (920) 496-4700 |
NPI Number | 1194748061 |
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Provider Enumeration Date | 07/25/2006 |
Last Update Date | 09/10/2008 |
Identifier | Type | State | Issuer |
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1194748061 | NPI | - | NPPES |
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 | |