| NPI | 1831547397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CURT KUBIAK CEO 920-560-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2023-12-06 |