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1386163731
JACK ALAN MICHAEL
WAUWATOSA, WI
NPI
1386163731
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 13960)
Enumeration Date
2017-09-18
Last Update Date
2017-09-18
Business Address
JACK ALAN MICHAEL DPT
2626 N 76TH ST STE 105
WAUWATOSA, WI 53213-1137
Phone number: 414-774-7794
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Mailing Address
JACK ALAN MICHAEL DPT
2626 N 76TH ST STE 105
WAUWATOSA, WI 53213-1137
Phone number: 414-774-7794
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