| NPI | 1568897445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY MARIE NICCOLAI Office Manager 262-598-0918 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 2961-12) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2021-12-06 |