Organization
THE NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, SC
Active
Organization
THE NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, SC
Active
Parent organization
THE NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C.
Other names
Neuroscience Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE NEUROSCIENCE GROUP OF NORTHEAST WISCONSIN, S.C.
Authorized official
PHILIP YAZBAK MD (SURGEON/PRESIDENT)
(800) 201-1194
Entity
Organization
Contact information
Practice address
1305 W AMERICAN DR, NEENAH, WI 54956-1993
(800) 201-1194
(920) 720-7392
Mailing address
1305 W AMERICAN DR, NEENAH, WI 54956-1993
(800) 201-1194
(920) 720-7392
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21284100
—
WI
Enumeration date
12/07/2016
Last updated
12/07/2016
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