| NPI | 1376086611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI ANN RICHBURG Partner 414-800-5359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 208VP0000X |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2024-07-08 |