| NPI | 1003283516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BARNETT Administrator 920-257-2005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 13033-24) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2015-09-01 |