| NPI | 1194011346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD REDMAN Clinic Director 608-242-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WI 15375-131) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-06-27 |