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
1001 W MAIN ST, WAUPUN, WI 53963-1601
(920) 324-9301
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/28/2012
Last updated
07/05/2012
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