| NPI | 1376087957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN D WEISSMAN Owner 414-434-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2018-08-20 |