Community Medical Center of Green Lake, LLC
NPI #1568622280 in Green Lake, Wisconsin
Provider Information
- NPI Number
- 1568622280
- Entity Type
- Organization
- Organization Name
- Community Medical Center of Green Lake, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jun 16, 2008
- Last Updated
- May 2, 2014
Practice Location
- Address
- 670 COUNTY ROAD A
- City
- Green Lake
- State
- Wisconsin
- ZIP Code
- 54941
- Phone
- (920) 294-0100
Authorized Official
- Name
- MR. THOMAS KRYSTOWIAK
- Title
- CHIEF FINANCIAL OFFICER
- Phone
- (920) 361-1313
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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