Fmg North 13th Street Wisconsin LLC

NPI #1457740250 in Sheboygan, Wisconsin

Provider Information

NPI Number
1457740250
Entity Type
Organization
Organization Name
Fmg North 13th Street Wisconsin LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Jan 16, 2015
Last Updated
Jan 16, 2015

Practice Location

Address
3431 N 13TH ST
ZIP Code
53083-2938
Phone
(920) 457-5046

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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