Organization
AGNESIAN HEALTHCARE INC
Active
Other names
SSM HEALTH FOND DU LAC REGIONAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRINNELL (VP-FINANCE, CFO)
(608) 260-3586
Entity
Organization
Contact information
Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 926-8332
Mailing address
1808 W BELTLINE HWY, MADISON, WI 53713-2334
(608) 250-1593
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/04/2006
Last updated
06/05/2024
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