| NPI | 1356584932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOHN BOHO President And Owner 262-497-8798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: WI 919-026) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-04-15 |