Healthcare Provider Details

I. General information

NPI: 1154799435
Provider Name (Legal Business Name): MICHAEL GANAS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2015
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10025 W GREENFIELD AVE STE 100
WEST ALLIS WI
53214-3957
US

IV. Provider business mailing address

10025 W GREENFIELD AVE STE 100
WEST ALLIS WI
53214-3957
US

V. Phone/Fax

Practice location:
  • Phone: 414-258-9777
  • Fax: 414-327-0988
Mailing address:
  • Phone: 414-258-9777
  • Fax: 414-327-0988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5110-12
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: