| NPI | 1417427766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARINA CHELSKY Administrator 414-467-8884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2018-11-29 |