| NPI | 1487015723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES S FLEUCHAUS Owner Member 414-456-9896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WI 2716-012) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2016-03-15 |