| NPI | 1780859454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARIE O'CONNELL Physical Therapy Assistant 920-682-0314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |