| NPI | 1942524780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY A PATTEE Practice Manager 920-885-5225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2024-01-11 |