| NPI | 1770886392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH J JARES Owner 920-284-5243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X Psychiatry & Neurology, Clinical Neurophysiology (Licence: WI 42460020) |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2010-12-21 |