Organization
AGNESIAN HEALTHCARE INC
Active
Organization
AGNESIAN HEALTHCARE INC
Active
Other names
FOND DU LAC REGIONAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN N LITTLE (SVP & CFO)
(920) 926-5402
Entity
Organization
Contact information
Practice address
703 W STATE ST, FOX LAKE, WI 53933-9550
(920) 928-6300
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/29/2006
Last updated
11/26/2007
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