NPI | 1477964211 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY SUE EICHMAN Registered Nurse 715-377-9617 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: WI 124164-030) |
Enumeration Date | 2014-05-14 |
Last Update Date | 2014-05-14 |