| NPI | 1497768659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SCOTT LOVELY Executive Director 414-771-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2013-03-27 |