| NPI | 1760563829 |
|---|---|
| Doing Business As | WISCONSIN PVP |
| Entity Type | Organization |
| Authorized Contact | THERESA DAVIS Director, Cbo 512-314-4331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QL0400X Clinic/Center, Lithotripsy |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2008-06-27 |