Organization
CHILDREN'S HOSPITAL OF WISCONSIN
Active
Other names
Child Advocacy Center - Fox Valley
Organization subpart
No
Provider details
NPI number
Authorized official
WELDON GAGE (TREASURER/CHIEF FINANCIAL OFFICER)
(414) 266-6401
Entity
Organization
Contact information
Practice address
2575 E EVERGREEN DR, APPLETON, WI 54913-8910
(920) 969-7930
(920) 969-7975
Mailing address
9000 W WISCONSIN AVE, MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
01/31/2013
Last updated
02/24/2023
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