| NPI | 1801293063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE VANDE HEI Physical Therapist 920-606-8065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 1215936430) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |