| NPI | 1588839492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ANN KNUDSEN Physical Therapist Assistant 920-494-5231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |