| NPI | 1457693723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA DANOSKI Clinic Director 414-967-7006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: WI 15281-132) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2013-03-25 |