Healthcare Provider Details

I. General information

NPI: 1659302867
Provider Name (Legal Business Name): KURT PATRICK HUEMMER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2060 N HUMBOLDT BLVD
MILWAUKEE WI
53212-3504
US

IV. Provider business mailing address

2060 N HUMBOLDT BLVD
MILWAUKEE WI
53212-3504
US

V. Phone/Fax

Practice location:
  • Phone: 414-265-5606
  • Fax: 414-265-5649
Mailing address:
  • Phone: 414-265-5606
  • Fax: 414-265-5649

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3303
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: