Organization
ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN, INC
Active
Other names
Ascension Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE SANICOLA (ADMINISTRATIVE VP)
(414) 465-3968
Entity
Organization
Contact information
Practice address
618 MEMORIAL DR, CHILTON, WI 53014
(920) 849-3800
Mailing address
1570 MIDWAY PL, MENASHA, WI 54952-1165
(920) 720-1464
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/16/2006
Last updated
09/06/2018
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