| NPI | 1063433977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY L MACKMAN Director 414-476-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2471C3401X Radiologic Technologist, Computed Tomography | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2023-08-25 |