| NPI | 1457554990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDRIC WILL Owner 262-637-2050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 25744-020) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2008-02-04 |