| NPI | 1336391127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN T O'DELL Owner 920-564-6107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: WI 5421-024) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2008-10-13 |