| NPI | 1396835328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L HOFFMAN Owner 920-686-1822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: WI 37871020) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |