| NPI | 1861667248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LEE WILLIQUETTE Physical Therapist Assistant 920-922-7324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WI 172-019) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |