Organization
AGNESIAN HEALTHCARE INC
Active
Other names
FOND DU LAC REGIONAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN N LITTLE (PRESIDENT & CEO)
(920) 926-5402
Entity
Organization
Contact information
Practice address
451 E BROOKLYN ST, CHILTON, WI 53014-1595
(920) 849-4682
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8332
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
12/12/2012
Last updated
12/12/2012
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