NPI | 1891980231 |
---|---|
Entity Type | Organization |
Authorized Contact | CARMEN MARIE JOHNS Office Manager 414-321-2273 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: WI 2547-012) |
Enumeration Date | 2007-09-10 |
Last Update Date | 2007-09-10 |