| NPI | 1396287355 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE WILLIAM CARDONE Medical Director 262-349-9371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2016-11-08 |