| NPI | 1942411152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SISCHO Owner 414-852-4022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 261QR0400X Clinic/Center Rehabilitation |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2020-08-22 |