| NPI | 1366439515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND GRUNDMAN Executive Director 414-325-4401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2020-08-22 |