| NPI | 1275107971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BOYINGTON Manager 262-226-6265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-05-17 |