| NPI | 1114143781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA K NIEMELA CEO 262-287-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-05-03 |