Organization
PREVEA REGIONAL SERVICES, INC.
Active
Other names
Prevea Regional
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD ROLSTON MD (PRESIDENT AND CEO)
(920) 496-4700
Entity
Organization
Contact information
Practice address
2710 EXECUTIVE DR, GREEN BAY, WI 54304-5496
(920) 496-4700
(920) 496-4705
Mailing address
PO BOX 19070, PREVEA HEALTH REGIONAL, GREEN BAY, WI 54307-9070
(920) 496-4700
(920) 496-4705
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/25/2006
Last updated
09/10/2008
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