NPI | 1619915741 |
---|---|
Entity Type | Organization |
Authorized Contact | CHASE L BEHRENDT Administrator 715-344-2164 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 0917050001) |
Enumeration Date | 2006-06-02 |
Last Update Date | 2014-02-19 |