Green Lake Medical Clinic

NPI #1316087885 in Green Lake, Wisconsin

Provider Information

NPI Number
1316087885
Entity Type
Organization
Organization Name
Green Lake Medical Clinic
Primary Specialty
Clinical Medical Laboratory
Enumeration Date
Feb 7, 2007
Last Updated
Aug 22, 2020

Practice Location

Address
N6205 BUSSE DRIVE
ZIP Code
54941-0429
Phone
(920) 294-3444

Authorized Official

Name
DR. THOMAS RICE WILLETT, D.O.
Title
PRESIDENT
Phone
(920) 294-3444

Specialties & Taxonomy Codes

Specialty
Clinical Medical Laboratory

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