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1679111793
SHANE SLAASTED
MILWAUKEE, WI
NPI
1679111793
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: WI 2954-19)
Enumeration Date
2019-12-19
Last Update Date
2019-12-19
Business Address
SHANE SLAASTED Pta
10101 W WISCONSIN AVE
MILWAUKEE, WI 53226-4861
Phone number: 414-259-6310
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Mailing Address
SHANE SLAASTED Pta
10101 W WISCONSIN AVE, MILWAUKEE, WI 53226
MILWAUKEE, WI 53226
Phone number:
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