| NPI | 1912277906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOHN SHEWCZYK Owner 262-375-1580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: WI 19364) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |