Organization
ORTHOPEDIC SURGERY CENTER OF GREEN BAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY FRAGALE (CHAIRMAN OF THE BOARD)
(920) 965-9520
Entity
Organization
Contact information
Practice address
2223 LIME KILN RD STE 2, GREEN BAY, WI 54311-6213
(920) 965-9520
Mailing address
2223 LIME KILN RD STE 1, GREEN BAY, WI 54311-6213
(920) 965-9520
(920) 430-8122
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
WI
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/23/2009
Last updated
01/18/2021
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