Organization
ADVANCED SPINE CENTER OF WISCONSIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN BAILEY (OFFICER/AUTHORIZED OFFICIAL)
(203) 609-1168
Entity
Organization
Contact information
Practice address
1380 TULLAR RD, NEENAH, WI 54956-4440
(920) 205-0379
Mailing address
1380 TULLAR RD, NEENAH, WI 54956-4440
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
02/03/2025
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