| NPI | 1316918345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES STAUBS Physician Owner 715-409-0121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WI 50267-21) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD H42911) |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2013-05-09 |