| NPI | 1043320245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLA MARIE SCHLIMGEN Co Owner 715-830-0732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WI 35856) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |