| NPI | 1093771743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS M THOMPSON Administrator 920-451-3240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207RA0201X Internal Medicine, Allergy & Immunology |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2020-08-22 |