Graduated: 2006
NPI: 1215078662
Practice Locations (3)
101 PRIMROSE LN
Green Bay, WI 543116882
101 PRIMROSE LN
GREEN BAY, WI 543116882
840 CHALLENGER DR, SUITE 130
GREEN BAY, WI 543118351
9207124526
Source: CMS National Downloadable File, September 2026.