Healthcare Provider Details

I. General information

NPI: 1730648452
Provider Name (Legal Business Name): 8 BRANCHES CHINESE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 S KINNICKINNIC AVE
MILWAUKEE WI
53207-3144
US

IV. Provider business mailing address

3401 S KINNICKINNIC AVE
MILWAUKEE WI
53207-3144
US

V. Phone/Fax

Practice location:
  • Phone: 414-751-0888
  • Fax:
Mailing address:
  • Phone: 414-751-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: SHERI LM LEE
Title or Position: OWNER
Credential: LAC, LMT
Phone: 414-750-5444