| NPI | 1306425251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP AIR GUTKOWSKI Business Manager 608-373-4871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-04-07 |