| NPI | 1629498522 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN BITTORF Medical Director 920-491-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WI 46205-20) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |