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General NPI Number Information
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NPI Number | 1437469400
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Entity Type | Organization
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Legal Business Name | MUSHIN PLLC
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Dates
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Enumeration Date | 10/08/2010
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 2100 GATEWAY CT STE 100
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City | WEST BEND
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State | WI
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Zip | 53095-8550
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Country | US
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Telephone | 262-334-8188
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 GATEWAY CT STE 100
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City | WEST BEND
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State | WI
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Zip | 53095-8550
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Country | US
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Telephone | 262-334-8188
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Fax | 262-334-8166
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. FREDERICK JAMES SCHOFIELD
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Credential | D.C.
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Telephone | 262-334-8188
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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 | 4575-12
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License Number State | WI
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