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General NPI Number Information
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NPI Number | 1851427843
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Entity Type | Organization
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Legal Business Name | MILWAUKEE AFFILIATED CHIROPRACTIC SERVICES, INC.
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9001 N 76TH ST SUITE 200
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City | MILWAUKEE
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State | WI
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Zip | 53223-1911
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Country | US
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Telephone | 414-365-2400
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Fax | 414-365-2419
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Provider Business Mailing Address
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Address Line | 9001 N 76TH ST SUITE 200
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City | MILWAUKEE
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State | WI
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Zip | 53223-1911
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Country | US
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Telephone | 414-365-2400
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Fax | 414-365-2419
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. RENEE LYNN YORK
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Credential |
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Telephone | 414-365-2400
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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 | 1852
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License Number State | WI
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