| NPI | 1326441841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON P KONZEN Member 715-831-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 37138021) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |