SPACE COAST FAMILY PRACTICE is a clinic center in Green Bay, WI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SPACE COAST FAMILY PRACTICE NPI is 1811099054. The provider is registered as an organization entity type.
The provider's business location address is:
3067 WINDLAND DR
GREEN BAY, WI
ZIP 54311-574
Phone: (920) 544-5868
The provider's authorized official is Thomas Charles Betka .
The authorized official title is President and has the following contact phone number (920) 544-5868.
The enumeration date for this NPI number is 9/1/2006 and was last updated on 8/22/2020.