| NPI | 1750684304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JACOB JONES Owner/Doctor 920-267-2651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WI 4642-012) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2010-12-20 |