Ascension Medical Group-Fox Valley Wisconsin, INC

NPI #1477658110 in Appleton, Wisconsin

Provider Information

NPI Number: 1477658110
Entity Type: Organization
Organization Name: Ascension Medical Group-Fox Valley Wisconsin, INC
Primary Specialty: Durable Medical Equipment & Medical Supplies
Enumeration Date: Sep 14, 2006
Last Updated: Aug 22, 2018

Practice Location

Address: 3329 N RICHMOND ST
City: Appleton
State: Wisconsin
ZIP Code: 54911
Phone: (920) 730-8414

Authorized Official

Name: SUZANNE SANICOLA
Title: ADMINISTRATIVE VP
Phone: (414) 465-3968

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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