| NPI | 1144273913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W BAILET President 414-647-3047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2013-04-04 |