| NPI | 1205993946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES N KAGEN Owner 920-733-5138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: WI 24388-020) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |