| NPI | 1225296874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HEITMANN Owner 608-271-8009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: WI 4401-12) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-05-30 |