| NPI | 1629368337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MOBERG-WOLFF Owner 262-527-1998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: WI 32483020) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2023-02-01 |