| NPI | 1780628925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY SOMMERVILLE Director 920-731-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2022-05-11 |