| NPI | 1174714653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LEE JOHNSON President 920-739-6971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 111NN0400X Chiropractor, Neurology |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2022-05-09 |