| NPI | 1285716308 |
|---|---|
| Other Name | RAVENSWOOD CLINIC |
| Entity Type | Organization |
| Authorized Contact | ANTHONY FRANCIS WERTH Executive Director 414-224-0492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: WI 2118) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2014-03-27 |