| NPI | 1366995136 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS JON General Manager 414-282-7209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 016.005682) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2018-07-31 |