| NPI | 1104804012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A SERVAIS Owner 920-468-1963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 4055012) |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology (Licence: WI 1783012) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2010-02-19 |