Individual
STACEY M NELLEN-KOLZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2031 S WEBSTER AVE, SUITE B, GREEN BAY, WI 54301-2257
(920) 393-4912
(920) 393-4913
Mailing address
2031 S WEBSTER AVE, SUITE B, GREEN BAY, WI 54301-2257
(920) 393-4912
(920) 393-4913
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
456-1026562299-04
WI
Other
Enumeration date
02/12/2013
Last updated
02/12/2013
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