| NPI | 1164655882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW RUST Owner/President 715-341-3318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: WI 2810) |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |