| NPI | 1730909664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GODDARD Chief Operating Officer 715-261-8557 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |