| NPI | 1356042444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE LISA WILDNER Director Of Contracting & Research 262-875-6572 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Additional Taxonomies | 2472E0500X Technician, Other, EEG |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| 293D00000X Physiological Laboratory | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2024-06-18 |