| NPI | 1861514713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LOY Interim CEO 715-848-4600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: WI 2562) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2017-08-01 |