Graduated: 2022
NPI: 1720795313
Practice Locations (2)
THEDACARE, INCORPORATED
3925 N GATEWAY DR
APPLETON, WI 549137863
9204548401
THEDACARE MEDICAL CENTER - SHAWANO, INC.
100 COUNTY RD B
SHAWANO, WI 541667072
7155262111
Source: CMS National Downloadable File, September 2026.