| NPI | 1871586651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE LEE WOLF Administrator 715-843-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2011-10-17 |