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Facility Name
Theda Clark Medical Center
Provider Number
52-0045; 000071445
Date approved
10/21/2005
State
WI
Address 1
130 Second Street
Address 2
Neenah, WI 54956
Other Information
ACS - 02/24/2005; ASMBS - 10/21/2005; Telephone: 920-729-3100; Andrea Wolff - (920) 720-7281