| NPI | 1770611808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN PAUL CORSI CFO 262-253-6779 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WI 3243) |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2017-09-27 |