| NPI | 1649462938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH GRAY Assistant Administrator Operations 608-364-1348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2007-08-10 |
| Last Update Date | 2007-08-10 |