NPI | 1649520008 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK V LORSON CEO 414-207-0309 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
Additional Taxonomies | 261QP0905X Clinic/Center Public Health, State or Local |
Enumeration Date | 2012-09-13 |
Last Update Date | 2012-09-13 |