Organization
AGNESIAN HEALTHCARE INC
Active
Other names
FOND DU LAC REGIONAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE VERGOS (PRESIDENT)
(920) 926-4979
Entity
Organization
Contact information
Practice address
900 MAIN ST, BROWNSVILLE, WI 53006-0187
(920) 926-8375
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/04/2006
Last updated
05/08/2019
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