Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-02-01
- Last updated
- 2020-08-22
Specialties
Licenses
- License WI
- 1307
Location
- Practice location
- 316 STEELE ST
- City
- ALGOMA WI
- Postal code
- 542011265
- Phone
- 920-487-9909
Organization contact
- Name
- KAY SECREST
- Title
- Owner
- Phone
- 9204879909
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.