| NPI | 1306125323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD OLVIS MONDANO President 414-736-6807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: IN 05008118A) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: IN 05007708A) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-08-08 |