| NPI | 1922334101 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY FRAGALE Chairman Of The Board 920-965-9520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2021-01-18 |