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General NPI Number Information
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NPI Number | 1073665923
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Entity Type | Organization
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Legal Business Name | DRS. DAHLGREN & NEITZKE, INC.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 04/05/2013
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Provider Practice Location Address
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Address Line | 7311 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-4730
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Country | US
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Telephone | 414-453-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 7311 W GREENFIELD AVE
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City | WEST ALLIS
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State | WI
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Zip | 53214-4730
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Country | US
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Telephone | 414-453-1010
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY ALBERT DAHLGREN
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Credential | O.D.
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Telephone | 414-453-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State | WI
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