| NPI | 1790216554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY T.J. STRAKA Owner 414-899-2385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WI H059290) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2024-08-09 |