| NPI | 1386968428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN D HOLZMACHER President 414-202-1724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WI 42642-020) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-09-30 |