Healthcare Provider Details

I. General information

NPI: 1063489292
Provider Name (Legal Business Name): WELLNESS CENTER OF DOOR COUNTY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 N 5TH AVENUE
STURGEON BAY WI
54235
US

IV. Provider business mailing address

PO BOX 85 312 N 5TH AVE
STURGEON BAY WI
54235
US

V. Phone/Fax

Practice location:
  • Phone: 920-746-9444
  • Fax: 920-746-9466
Mailing address:
  • Phone: 920-746-9444
  • Fax: 920-746-9466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELE GEIGER-BRONSKY
Title or Position: EXECUTIVE DIRECTOR
Credential: MSN APNP
Phone: 920-746-9444