| NPI | 1306892922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE K CHASE CEO 262-241-1701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WI 647186) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2008-12-11 |