Fmg New Pine Drive Wisconsin LLC

NPI #1740679547 in Altoona, Wisconsin

Provider Information

NPI Number
1740679547
Entity Type
Organization
Organization Name
Fmg New Pine Drive Wisconsin LLC
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Jan 16, 2015
Last Updated
Jan 16, 2015

Practice Location

Address
2512 NEW PINE DR
ZIP Code
54720-1378
Phone
(715) 833-0400

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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