Organization
AVIVA MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE PODLASIK CRNA (CRNA/CEO)
(920) 510-9381
Entity
Organization
Contact information
Practice address
645 CARDINAL LN, GREEN BAY, WI 54313-6730
(920) 510-9381
Mailing address
645 CARDINAL LN, GREEN BAY, WI 54313-6730
(920) 510-9381
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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