| NPI | 1326555442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAREY CAMERON Managing Member 262-355-8010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2019-12-09 |