| NPI | 1679064638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE LISA WILDNER Director Of Contracting And Researc 262-875-6572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory |
| Additional Taxonomies | 261QS1200X Clinic/Center, Sleep Disorder Diagnostic |
| 2472E0500X | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2018-05-25 |
| Last Update Date | 2019-03-09 |