| NPI | 1992470512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HAUGEN Medical Director 608-358-6901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-16 |