Organization
FOND DU LAC COUNTY DSS PERSONAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH A RYAN (BUSINESS SYSTEMS MANAGER)
(920) 929-3437
Entity
Organization
Contact information
Practice address
87 VINCENT ST, FOND DU LAC, WI 54935-4510
(920) 929-3437
Mailing address
87 VINCENT ST, FOND DU LAC, WI 54935-4510
(920) 929-3437
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43103400
—
WI
Enumeration date
08/14/2007
Last updated
08/14/2007
Update your record
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