NPI | 1558751248 |
---|---|
Entity Type | Organization |
Authorized Contact | DANIEL T O'CONNOR Physician / Owner 262-297-3657 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: WI 50669-020) |
Enumeration Date | 2015-02-02 |
Last Update Date | 2015-02-02 |