| NPI | 1306045000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN B DONNELLY Chiropractor 414-607-0366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: WI 3784-012) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 3785-012) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2017-03-09 |