# FOX VALLEY OPEN MRI, LLC

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

## Provider details

- **NPI number:** 1881697837
- **Authorized official:** MRS. MICHELLE DOUGLAS (CREDENTIALING MANAGER)
- **Authorized official phone:** (502) 403-1401

## Contact information

- **Practice address:** 201 W NORTHLAND AVE, APPLETON, WI 54911-2039
- **Practice address phone:** (920) 996-0724
- **Practice address fax:** (920) 996-0728
- **Mailing address:** 201 W NORTHLAND AVE, APPLETON, WI 54911-2039
- **Mailing address phone:** (920) 996-0724
- **Mailing address fax:** (920) 996-0728

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 06/12/2008