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Organization
FOX VALLEY PATHOLOGISTS SC
Active
Organization
FOX VALLEY PATHOLOGISTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARLA SENDELBACH-ELIZONDO MD (SECRETARY/TREASURER)
(800) 288-8325
Entity
Organization
Contact information
Practice address
130 SECOND STREET, NEENAH, WI 54956
(920) 729-3000
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52D0397435
AMC CLIA
WI
01
—
52D0397878
TCMC CLIA
WI
Enumeration date
09/12/2006
Last updated
11/11/2022
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