| NPI | 1659569705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN L. BALKANSKY President 262-375-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP1100X Clinic/Center Podiatric (Licence: WI 429025) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2011-12-22 |