Organization
INNOVATION ALLIANCE IPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CURT KUBIAK (CEO)
(920) 560-1001
Entity
Organization
Contact information
Practice address
2105 E ENTERPRISE AVE, SUITE 101, APPLETON, WI 54913-7862
(920) 560-1100
(920) 560-1112
Mailing address
691 S GREEN BAY RD # 168, NEENAH, WI 54956-3153
(920) 209-4440
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
05/25/2016
Last updated
12/06/2023
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