| NPI | 1972720647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY T MALONE Doctor 262-597-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NN1001X Chiropractor, Nutrition (Licence: WI 3473-012) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-08-22 |