| NPI | 1417141227 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | ALYSSA K STEPHENSON President 262-637-8806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2012-01-27 |