| NPI | 1588312482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE SAUER Administrator 920-730-8833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 174400000X Specialist |
| 207X00000X Orthopaedic Surgery | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-03-10 |
| Last Update Date | 2022-03-10 |