| NPI | 1902494859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MCPHERSON Medical Director 920-227-9214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-01-06 |
| Last Update Date | 2021-01-06 |