| NPI | 1629356423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DONALD MATTEUCCI President 262-945-1094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2011-12-07 |