| NPI | 1437271012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE D BAUER P.T. 920-929-9712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WI 5173024) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-07-02 |