Green Lake Medical Clinic , S.c.
NPI #1306986716 in Green Lake, Wisconsin
Provider Information
- NPI Number
- 1306986716
- Entity Type
- Organization
- Organization Name
- Green Lake Medical Clinic , S.c.
- Primary Specialty
- Family Medicine
- Enumeration Date
- Feb 7, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- N6205 BUSSE DRIVE
- City
- Green Lake
- State
- Wisconsin
- ZIP Code
- 54941
- Phone
- (920) 294-3444
Authorized Official
- Name
- DR. THOMAS RICE WILLETT, D.O.
- Title
- PRESIDENT
- Phone
- (920) 294-3444
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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