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General NPI Number Information
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NPI Number | 1790080984
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC COMPANY - MILWAUKEE EAST LTD.
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 2332 N FARWELL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-4401
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Country | US
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Telephone | 414-223-4550
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Fax | 414-354-0523
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Provider Business Mailing Address
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Address Line | 2332 N FARWELL AVE
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City | MILWAUKEE
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State | WI
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Zip | 53211-4401
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Country | US
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Telephone | 414-223-4550
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Fax | 414-354-0523
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. KENT L. MCLEOD
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Credential | DC
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Telephone | 414-223-4550
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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 | 4056
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License Number State | WI
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