| NPI | 1003035767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA J KING Office Manager 920-233-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 3756-024) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |