Graduated: 2013
NPI: 1699017913
Practice Locations (2)
THEDACARE, INCORPORATED
100 COUNTY RD B
SHAWANO, WI 541667072
9203581223
THEDACARE MEDICAL CENTER - SHAWANO, INC.
100 COUNTY RD B
SHAWANO, WI 541667072
7155262111
Source: CMS National Downloadable File, September 2026.