Organization
SHAWANO CLINIC, INC
Active
Other names
ThedaCare Physicians Shawano
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L THERN (REIMBURSMENT SPECIALIST)
(920) 996-3298
Entity
Organization
Contact information
Practice address
117 E GREEN BAY ST, SHAWANO, WI 54166-2443
(920) 996-3298
Mailing address
PO BOX 8003, APPLETON, WI 54912-8003
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
04/09/2007
Last updated
08/22/2020
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