| NPI | 1922468891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEA O'CONNOR Accounting And Finance Coordinator 920-887-1766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 27426020) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-03-04 |