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General NPI Number Information
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NPI Number | 1285797381
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Entity Type | Organization
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Legal Business Name | SMASAL FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 2900 N 117TH ST SUITE 100
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City | WAUWATOSA
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State | WI
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Zip | 53222-4106
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Country | US
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Telephone | 414-774-6757
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Fax | 414-774-6734
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Provider Business Mailing Address
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Address Line | 2900 N 117TH ST
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City | WAUWATOSA
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State | WI
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Zip | 53222-4106
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Country | US
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Telephone | 414-774-6757
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Fax | 414-774-6734
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARAH A SMASAL
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Credential | D.C.
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Telephone | 414-774-6757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4101-012
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License Number State | WI
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