| NPI | 1548660012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA FLIPPIN President 414-793-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: VI 1205) |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2014-09-03 |