Organization
FMG MEAD AVENUE WISCONSIN LLC
Active
Other names
Sheboygan Progressive Care
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KEATING (AUTHORIZED OFFICIAL)
(414) 908-8058
Entity
Organization
Contact information
Practice address
1902 MEAD AVE, SHEBOYGAN, WI 53081-6140
(920) 458-8333
(920) 458-3346
Mailing address
1902 MEAD AVE, SHEBOYGAN, WI 53081-6140
(920) 458-8333
(920) 458-3346
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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