| NPI | 1164265096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON DELONG Owner 715-495-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 103T00000X Psychologist |
| 207Q00000X Family Medicine | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2025-01-06 |