Organization
BRIDGE TO HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE LEE GROESSL MSN (OWNER/NURSE PRACTITIONER)
(920) 434-8500
Entity
Organization
Contact information
Practice address
2149 VELP AVE, SUITE 205, GREEN BAY, WI 54303-5424
(920) 434-8500
(920) 468-9791
Mailing address
2149 VELP AVE, SUITE 205, GREEN BAY, WI 54303-5424
(920) 434-8500
(920) 468-9791
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
Primary
79614
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43845200
—
WI
Enumeration date
06/08/2009
Last updated
07/15/2009
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