Organization
AGNESIAN HEALTHCARE INC
Active
Other names
SSM HEALTH FOND DU LAC REGIONAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JO GRINNELL (VP-FINANCE)
(608) 229-7885
Entity
Organization
Contact information
Practice address
430 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-5676
(920) 926-8930
Mailing address
1808 W BELTLINE HWY, MADISON, WI 53713-2334
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
—
—
Other
Enumeration date
12/28/2022
Last updated
12/28/2022
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