| NPI | 1669731592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY JONES CEO 414-807-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: IL 036072534) |
| Enumeration Date | 2012-05-12 |
| Last Update Date | 2012-05-12 |