| NPI | 1013088665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENIFER I BASSETT Director President 715-830-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 45876) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 45876) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2009-03-10 |