| NPI | 1356499784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES J. FAUGHT CFO 715-463-7281 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 1034) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 1034) |
| 363L00000X Nurse Practitioner (Licence: WI 1034) | |
| 367A00000X Advanced Practice Midwife (Licence: WI 1034) | |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2012-01-04 |