| NPI | 1477530228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL HUBER Co Owner 920-451-8667 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2022-07-21 |