| NPI | 1952390783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL P HIPKE Business Director 715-732-2075 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: WI 52D0710136) |
| 207R00000X Internal Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2014-11-13 |