| NPI | 1952679458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUIN O GARRETT Clinical Supervisor 414-442-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WI 396006491) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |