| NPI | 1003184474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA M GUDELL Practice Manager 414-365-3210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: WI 47844-020) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2012-04-12 |