Organization
FPG & LCD LLC
Active
Other names
Stoney River Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY ANN CONWAY MS CCC-SLP, NHA (EXECUTIVE DIRECTOR)
(715) 298-3833
Entity
Organization
Contact information
Practice address
7805 BIRCH ST, WESTON, WI 54476-5219
(715) 298-3833
(715) 298-4284
Mailing address
7805 BIRCH ST, WESTON, WI 54476-5219
(715) 298-4226
(715) 298-3833
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100030434
—
WI
Enumeration date
05/06/2013
Last updated
04/09/2020
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