| NPI | 1497046254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY KREUSER Owner 262-689-6853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WI 1848-024) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |