| NPI | 1063682938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN K. ALLEN Director/Physician 608-785-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WI 28854) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2024-11-07 |