| NPI | 1639401755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH ALAN JOHNSON Licensed Practical Nurse 414-429-7880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WI 311777-031) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2010-02-01 |