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Organization
ORTHOPEDIC SURGERY CENTER OF GREEN BAY, LLC
Active
Organization
ORTHOPEDIC SURGERY CENTER OF GREEN BAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY FRAGALE (CHAIRMAN OF THE BOARD)
(920) 965-9520
Entity
Organization
Contact information
Practice address
2223 LIME KILN RD STE 2, GREEN BAY, WI 54311-6213
(920) 965-9520
Mailing address
2223 LIME KILN RD STE 1, GREEN BAY, WI 54311-6213
(920) 965-9520
(920) 430-8122
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QA1903X
Ambulatory Surgical Clinic/Center
—
WI
Other
Enumeration date
10/23/2009
Last updated
01/18/2021
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