| NPI | 1407857790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY WILBUR Credentialing 920-560-1194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2024-07-26 |