| NPI | 1265611586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ANDREW WOLFE Member 920-253-5851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WI 29319-020) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2007-11-02 |