| NPI | 1558695205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY RICHARDS Officer 608-728-4973 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WI 4523-012) |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |