| NPI | 1811063274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIRK SAUL HALVERSON President 920-733-5345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: WI 877) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2008-04-07 |