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Organization

ORTHOPAEDIC SPECIALISTS, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DIANE MARIE BOECKER (OFFICE MANAGER)
(920) 725-0077
Entity
Organization

Contact information

Practice address
1516 S COMMERCIAL ST, NEENAH, WI 54956-4802
(920) 725-0077
(920) 725-6535
Mailing address
1516 S COMMERCIAL ST, NEENAH, WI 54956-4802
(920) 725-0077
(920) 725-6535

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
332B00000X
Durable Medical Equipment & Medical Supplies
21334200
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
21334200
WI
Enumeration date
01/17/2007
Last updated
06/10/2009
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