| NPI | 1205347564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY KIRK Credentialing Specialist 414-967-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: WI 3825-012) |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2018-06-20 |