| Delo Sport And Stem Sc | |
|
2595 Development Dr Ste 140 Green Bay WI 54311-4267 | |
| (920) 632-7248 | |
| (920) 632-4249 |
| Full Name | Delo Sport And Stem Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 2595 Development Dr Ste 140, Green Bay, Wisconsin |
| Authorized Official Name and Position | Marjorie Jean Delo (PRESIDENT) |
| Authorized Official Contact | 9206327248 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delo Sport And Stem Sc 2595 Development Dr Ste 140 Green Bay WI 54311-4267 Ph: (920) 632-7248 | Delo Sport And Stem Sc 2595 Development Dr Ste 140 Green Bay WI 54311-4267 Ph: (920) 632-7248 |
| NPI Number | 1689220527 |
|---|---|
| Provider Enumeration Date | 08/15/2019 |
| Last Update Date | 03/04/2020 |
| Medicare PECOS PAC ID | 3274967195 |
|---|---|
| Medicare Enrollment ID | O20200102000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689220527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Primary |
| Provider Name | Marjorie J Delo |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1356424691 PECOS PAC ID: 3577463835 Enrollment ID: I20041101000235 |
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