| NPI | 1164227401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD CEPHUS Family Nurse Practitioner 262-450-5045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-07-02 |