Healthcare Provider Details

I. General information

NPI: 1275422941
Provider Name (Legal Business Name): REJWI LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16455 W BLUEMOUND RD STE 110
BROOKFIELD WI
53005-5921
US

IV. Provider business mailing address

16455 W BLUEMOUND RD STE 110
BROOKFIELD WI
53005-5921
US

V. Phone/Fax

Practice location:
  • Phone: 414-877-0348
  • Fax:
Mailing address:
  • Phone: 414-877-0348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SALINAS
Title or Position: PRESIDENT
Credential:
Phone: 414-877-0348