| NPI | 1265242762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOLIVEN C BAUTISTA President/Owner 414-732-1503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-03-06 |