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General NPI Number Information
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NPI Number | 1568803799
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Entity Type | Individual
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Provider Name | DORIS K MAYER CAC
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Gender | Female
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Dates
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Enumeration Date | 07/16/2013
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 6130 S 108TH ST
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City | HALES CORNERS
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State | WI
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Zip | 53130-2525
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Country | US
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Telephone | 414-687-8292
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Fax |
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Provider Business Mailing Address
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Address Line | 1626 N 48TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53208-2247
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Country | US
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Telephone | 414-687-8292
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 372-055
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License Number State | WI
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