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Specialty details in registry · Menasha, WI

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At a glance

1366 Appleton Rd, Menasha, WI 54952-1504

NPPES record updated Feb 26, 2018. Public records can lag behind changes at a practice.

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Practice location

1366 Appleton Rd
Menasha, WI 54952-1504

Professional details: NPI, taxonomy & registry record

NPI1437650397

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 101YP2500X
Enumeration date: Feb 26, 2018
Record updated: Feb 26, 2018

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

101YP2500X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

1366 Appleton Rd
Menasha, WI 54952-1504

Phone: (920) 221-6112

Mailing address

1366 APPLETON RD

MENASHA, WI 549521504

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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