Organization
NORTHEAST WISCONSIN TECHNICAL COLLEGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES BLUMREICH (CHIEF FINANCIAL OFFICER)
(920) 498-5701
Entity
Organization
Contact information
Practice address
2740 W MASON ST, GREEN BAY, WI 54303-4966
(920) 498-5543
Mailing address
2740 W MASON ST, P.O.BOX 19042, GREEN BAY, WI 54303-4966
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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