Organization
NEUROSPINE CENTER OF WISCONSIN, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA PERRONNE (ADMINISTRATOR)
(920) 882-8200
Entity
Organization
Contact information
Practice address
5320 MICHAELS DR, APPLETON, WI 54913-8446
(920) 882-8200
(920) 882-8210
Mailing address
5320 W MICHAELS DR, APPLETON, WI 54913-8446
(920) 882-8200
(920) 882-8210
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32884500
—
WI
Enumeration date
08/08/2006
Last updated
07/23/2024
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