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General NPI Number Information
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NPI Number | 1790057909
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Entity Type | Individual
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Provider Name | JEFFREY ADAM KING D.C
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Gender | Male
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 1155 N MAYFAIR RD SPINE CARE CLINIC AT PLANK ROAD
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City | MILWAUKEE
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State | WI
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Zip | 53226-3462
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Country | US
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Telephone | 414-955-7199
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Fax | 414-955-0110
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Provider Business Mailing Address
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Address Line | 1155 N MAYFAIR RD SPINE CARE CLINIC AT PLANK ROAD
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City | MILWAUKEE
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State | WI
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Zip | 53226-3462
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Country | US
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Telephone | 414-955-7199
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Fax | 414-955-0110
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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 | 4854-12
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License Number State | WI
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