Organization
ST. MARY'S HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESE B. PANDL (PRESIDENT AND CHIEF EXECUTIVE OFFIC)
(920) 884-5801
Entity
Organization
Contact information
Practice address
1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 498-4267
Mailing address
1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1193624
WI
Other
Enumeration date
10/29/2013
Last updated
12/22/2021
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