| NPI | 1417370602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA REISWIG Owner/Physician 414-526-1291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WI 52720-20) |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-04-03 |