Individual
MR. MARK THOMAS SIMONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
300 CROOKS STREET, GREEN BAY, WI 54301
(920) 436-6800
(920) 432-5966
Mailing address
PO BOX 22308, 300 CROOKS STREET, GREEN BAY, WI 54305-2308
(920) 436-6800
(920) 432-5966
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/31/2006
Last updated
04/24/2009
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