Space Coast Family Practice
Space Coast Family Practice is a Clinic/Center in Green Bay, Wisconsin. Licensed in Florida. Registered with an NPI since 2006.
- Licensed in
- FL
- In the registry since
- 2006
Practice location Address checks out
3067 Windland DrGreen Bay, WI 54311-7574
Phone: (920) 544-5868
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Clinic/Center (primary) | Taxonomy 261Q00000X · Licence ME88311 (FL) |
|---|
Record details
| NPI number | 1811099054 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Thomas Betka — President · (920) 544-5868 |
| NPI enumerated | September 1, 2006 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 3067 Windland Dr, Green Bay, WI 54311-7574 |
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