| NPI | 1275598302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY WILLBUR Chief Administrative Officer 414-208-4456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2020-11-02 |