| NPI | 1730126392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. BRYAN FISSEL VP Finance 414-465-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 208D00000X General Practice |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2023-03-27 |