| NPI | 1376913129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MOFFETT HARWOOD Sole Propriator 608-436-0506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: WI 478-228) |
| Additional Taxonomies | 251S00000X (Licence: WI 2694-226) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |