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General NPI Number Information
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NPI Number | 1750588513
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Entity Type | Individual
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Provider Name | KATHRYN JEAN MEAD D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 08/17/2011
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Provider Practice Location Address
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Address Line | W5675 CTY HWY B
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City | SHAWANO
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State | WI
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Zip | 54166-0060
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Country | US
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Telephone | 715-526-6158
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Fax |
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Provider Business Mailing Address
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Address Line | 215 PROSPECT CIR
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City | SHAWANO
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State | WI
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Zip | 54166-3625
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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 | 4324-012
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License Number State | WI
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