Healthcare Provider Details

I. General information

NPI: 1023164837
Provider Name (Legal Business Name): MICHAEL ALAN HOELZER M.S.-ATR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2245 N 66TH ST
WAUWATOSA WI
53213-2037
US

IV. Provider business mailing address

2245 N 66TH ST
WAUWATOSA WI
53213-2037
US

V. Phone/Fax

Practice location:
  • Phone: 414-443-9987
  • Fax:
Mailing address:
  • Phone: 414-443-9987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number#05-088
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: