Organization
FROEDTERT HEALTH
Active
Parent organization
FROEDTERT HEALTH
Other names
Froedtert & MCW Community Physicians
Organization subpart
Yes
Provider details
NPI number
Legal business name
FROEDTERT HEALTH
Authorized official
BLAINE JOHN O'CONNELL (CFO)
(414) 805-4291
Entity
Organization
Contact information
Practice address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 476-6232
Mailing address
1650 S 41ST ST, MANITOWOC, WI 54220-7316
(920) 476-6232
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
12/29/2021
Last updated
12/29/2021
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