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General NPI Number Information
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NPI Number | 1316075377
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Entity Type | Individual
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Provider Name | SUSAN L. FLEUCHAUS DC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 5027 GREEN BAY RD SUITE 110
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City | KENOSHA
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State | WI
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Zip | 53144-1771
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Country | US
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Telephone | 262-652-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 5027 GREEN BAY RD SUITE 110
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City | KENOSHA
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State | WI
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Zip | 53144-1771
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2998-012
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License Number State | WI
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