| NPI | 1508232125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MICHAEL HAUKE Owner/ President 262-695-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WI 3975-012) |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-18 |