| NPI | 1295717445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN D MAIN Partner 262-764-5891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 207XS0106X Orthopaedic Surgery, Hand Surgery | |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2018-09-19 |