Provider First Line Business Practice Location Address:
704 S WEBSTER AVE
Provider Second Line Business Practice Location Address:
OBGYN ASSOCIATES OF GREEN BAY LTD
Provider Business Practice Location Address City Name:
GREEN BAY
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-468-3443
Provider Business Practice Location Address Fax Number:
920-432-6313
Provider Enumeration Date:
12/06/2006