| NPI | 1063802445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA SUE HELLWIG-COTTRELL Owner 608-317-7327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WI 3447-125) |
| Additional Taxonomies | 251S00000X (Licence: WI 4303-123) |
| 251S00000X (Licence: WI 6938-123) | |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-01-23 |