Fmg South 13th Street Wisconsin LLC

NPI #1376932178 in Sheboygan, Wisconsin

Provider Information

NPI Number
1376932178
Entity Type
Organization
Organization Name
Fmg South 13th Street Wisconsin LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Jan 16, 2015
Last Updated
Jan 16, 2015

Practice Location

Address
3613 S 13TH ST
ZIP Code
53081-7253
Phone
(920) 458-4040

Authorized Official

Name
DAVID KEATING
Title
AUTHORIZED OFFICIAL
Phone
(414) 908-8058

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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