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Organization

NEW MOMS OF GREEN BAY SC

Active
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Organization

NEW MOMS OF GREEN BAY SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANNON M TERRIEN (BUSINESS OFFICE)
(920) 431-0200
Entity
Organization

Contact information

Practice address
704 S WEBSTER AVE, STE 110, GREEN BAY, WI 54301-3528
(920) 431-0200
Mailing address
704 S WEBSTER AVE, STE 110, GREEN BAY, WI 54301-3528
(920) 431-0200

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—

Other

Enumeration date
02/05/2007
Last updated
10/21/2009
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