| NPI | 1265799928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE DOUGLAS COOK Chiropractor 920-842-2083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WI 2031-012) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2012-05-09 |