| NPI | 1851343115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARI B ADANK Cco 608-775-8025 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 261QD0000X Clinic/Center, Dental | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-08-06 |