| NPI | 1396428330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE K STROOBANTS Credentialing Specialist 920-433-7864 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |