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General NPI Number Information
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NPI Number | 1487316634
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Entity Type | Organization
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Legal Business Name | MSK HEALTHCARE LLC
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 02/01/2022
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Provider Practice Location Address
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Address Line | 114 E GREENFIELD AVE
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City | MILWAUKEE
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State | WI
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Zip | 53204-2966
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Country | US
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Telephone | 414-220-0106
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Fax |
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Provider Business Mailing Address
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Address Line | 430 E ESTATES PL
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City | OAK CREEK
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State | WI
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Zip | 53154-5122
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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 | OWNER
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Name | MAGGIE MAY KASTEN
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Credential | D.C.
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Telephone | 414-430-7005
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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 |
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License Number State |
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