| NPI | 1558557082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS A KOCH Owner 262-784-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI 111N00000X) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2007-10-03 |