| NPI | 1689058638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY SEVERINSEN Manager, President Of Board 414-943-2915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: WI 502055) |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-07-18 |