| NPI | 1083755177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY F JETZER Chief Financial Officer 414-479-9249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2024-10-21 |