| NPI | 1235766833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PUTZ Vice P Resident 218-330-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2025-11-15 |