| NPI | 1487773255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN J QUERLO Clinic Director 920-884-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 2948-012) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: WI 30743-020) |
| 146N00000X Emergency Medical Technician, Basic (Licence: WI 1064023) | |
| 363AM0700X Physician Assistant, Medical (Licence: WI S81585) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2009-03-06 |