| NPI | 1740271287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA LARUE Office Manager 920-457-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology |
| Additional Taxonomies | 2085R0203X Radiology, Therapeutic Radiology |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2008-04-20 |