| NPI | 1134556657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | H RICHARD WEINER Practice Operator 920-997-0511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: WI 29316-20) |
| Enumeration Date | 2013-09-29 |
| Last Update Date | 2013-09-29 |