| NPI | 1770605628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY D. OLSEN Executive Director 715-848-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: WI 1677) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2023-10-20 |