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Organization

THEDA CLARK HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DAWN MARIE FORCEY PTA (PHYSICAL THERAPIST ASSISTANT)
(920) 833-7508
Entity
Organization

Contact information

Practice address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-3100
Mailing address
130 2ND ST, NEENAH, WI 54956-2883
(920) 729-3100

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
475-019
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36122500
WI
Enumeration date
09/18/2007
Last updated
09/18/2007
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