| NPI | 1285752659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL DETRICK CEO 920-834-4621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0050X Clinic/Center Family Planning, Non-Surgical |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2022-05-02 |