# MANITOWOC SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033140397
- **Authorized official:** MRS. KATHLEEN SUE WILLHITE MSOLQ (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (920) 683-1250

## Contact information

- **Practice address:** 1720 MEMORIAL DRIVE, MANITOWOC, WI 54220
- **Practice address phone:** (920) 683-1250
- **Practice address fax:** (920) 683-1279
- **Mailing address:** 1720 MEMORIAL DRIVE, MANITOWOC, WI 54220
- **Mailing address phone:** (920) 683-1250
- **Mailing address fax:** (920) 683-1279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 04/26/2010