| NPI | 1265589303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI MARIE RADISH Physical Therapist 920-225-7764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 9771-24) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |