| NPI | 1467682716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L MUELLER Member/Manager 715-536-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WI 1399) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |