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Intergrated Pain And Spine Care Sc

Chiropractor, Rehabilitation in Milwaukee, WI. Organization (NPI-2).

NPI number1457861007
StatusActive
Last updated in NPPESJun 20, 2018

Details

NPI
1457861007
Entity type
Organization (NPI-2)
Legal business name
Intergrated Pain And Spine Care Sc
Organization subpart
No
Enumeration date
Oct 10, 2017
Last updated
Jun 20, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111NR0400X Chiropractor, Rehabilitation3812-012WIYes

Practice location

5261 N Port Washington Rd Ste 100
Milwaukee, WI 53217-4903

Phone 414-967-9000 · Fax 414-332-3712

Mailing address

Po Box 170181
Glendale, WI 53217-8016

Phone 414-967-9000 · Fax 414-332-3712

Authorized official

Wendy Kirk
Credentialing Specialist
4149679000

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