MEDICARE: DR. KENT L MCLEOD D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4056-012	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710067194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENT L MCLEOD D.C.

Provider Business Mailing Address
First Line	:	2332 N FARWELL AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4401
Country	:	US
Telephone Number	:	414-223-4550
Fax Number	:	414-354-0523

Provider Business Practice Location Address
First Line	:	2332 N FARWELL AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4401
Country	:	US
Telephone Number	:	414-223-4550
Fax Number	:	414-354-0523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	08/25/2025

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