Organization
AURORA BAYCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANNE LEZOTTE (NETWORK CREDENTIALING COORD SR)
(414) 647-6326
Entity
Organization
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5459
(920) 288-5420
Mailing address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5459
(920) 288-5420
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
5572-26
WI
Other
Enumeration date
11/19/2014
Last updated
11/19/2014
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