Individual provider · NPI-1

Miguel Angel Bautista, L.Ac.

Acupuncturist · Milwaukee, WI

NPI number1528290327
StatusActive
Last updated in NPPESSep 1, 2009

Details

NPI
1528290327
Entity type
Individual (NPI-1)
Name
Miguel Angel Bautista
Credential
L.Ac.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 13, 2009
Last updated
Sep 1, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171100000X Acupuncturist637-055WIYes

Practice location

4318 W. Foresthowe Ave.
Milwaukee, WI 53219

Phone 847-224-6159 · Fax 847-829-3991

Mailing address

4318 W. Forest Home Ave.
Milwaukee, WI 53219

Phone 847-224-6159 · Fax 847-829-3991

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