Organization
AGNESIAN HEALTHCARE INC
Active
Other names
FOND DU LAC REGIONAL CLINC
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GRINNELL (VP-FINANCE, CFO)
(608) 260-3586
Entity
Organization
Contact information
Practice address
250 CAMELOT DR, FOND DU LAC, WI 54935-8029
(920) 923-7400
Mailing address
250 CAMELOT DR, FOND DU LAC, WI 54935-8029
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
—
—
Other
Enumeration date
06/19/2020
Last updated
06/05/2024
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