| NPI | 1588841605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE THOMPSON Office Manager 920-885-9238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: WI 20274) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2008-01-31 |