| NPI | 1093089161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN M KESTEL Member 262-241-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WI 2178-24) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |