| NPI | 1053617894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESSA SOKOL Owner 608-829-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WI 3089-35) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2023-02-20 |