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Organization

SPINE CAPITAL WISCONSIN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT KOFFIE MD (CEO)
(812) 756-8888
Entity
Organization

Contact information

Practice address
2105 E ENTERPRISE AVE FL 2, APPLETON, WI 54913-7862
(920) 333-8878
Mailing address
2105 E ENTERPRISE AVE, APPLETON, WI 54913-7862
(920) 333-8878

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
208600000X
Surgery Physician

Other

Enumeration date
02/14/2025
Last updated
12/23/2025
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