NPI | 1548427024 |
---|---|
Entity Type | Organization |
Authorized Contact | ZACHARY P PAPENDIECK Sole Member 920-886-1111 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WI 4405-12) |
Enumeration Date | 2008-05-21 |
Last Update Date | 2008-06-09 |