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
130 CORPORATE DR, BEAVER DAM, WI 53916-3116
(920) 887-3102
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8332
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/04/2018
Last updated
06/05/2024
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