| NPI | 1669111274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSEL LEIN Chief Executive Officer 414-531-4327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-08 |