| NPI | 1710287628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY P ELDRIDGE President 262-656-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WI 54685-20) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-10-26 |