| NPI | 1093096224 |
|---|---|
| Doing Business As | D/B/A BREAST SURGERY EXPERTS OF NORTHEAST WISCONSIN LLC |
| Entity Type | Organization |
| Authorized Contact | DANIEL DEGROOT CEO 920-846-3444 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 39597-20) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2012-01-13 |