Organization
AGNESIAN HEALTHCARE INC
Active
Other names
Fond du Lac Regional Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE RUTH VERGOS (PRESIDENT)
(920) 926-4979
Entity
Organization
Contact information
Practice address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 923-7400
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 923-7400
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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