| NPI | 1659305654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES VANDERMISSEN CEO 920-996-1046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-08-15 |