| NPI | 1386801322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS J WIESNER A/R 920-725-4008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WI 759025) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2010-07-20 |