| NPI | 1477798338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE WAGNER Office Manager 262-321-0240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2021-12-02 |