| NPI | 1225293079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY RADER Certified Dietitian 414-258-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WI 827029) |
| Enumeration Date | 2008-07-22 |
| Last Update Date | 2008-09-12 |