| NPI | 1376259275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RENEE FLACH Executive Director 715-520-3877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2025-10-29 |