| NPI | 1780986703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW DUMOND President 608-647-2119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: WI 1377) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2010-11-23 |