| NPI | 1427235712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER KORDIYAK President 920-482-9394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WI 30743-020) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2009-01-23 |