MEDICARE: CHIROPRACTIC COMPANY - MILWAUKEE EAST LTD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4056	WI

General Provider Information

NPI Number	:	1790080984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC COMPANY - MILWAUKEE EAST LTD.

Provider Business Mailing Address
First Line	:	2332 N FARWELL AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4401
Country	:	US
Telephone Number	:	414-223-4550
Fax Number	:	414-354-0523

Provider Business Practice Location Address
First Line	:	2332 N FARWELL AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53211-4401
Country	:	US
Telephone Number	:	414-223-4550
Fax Number	:	414-354-0523

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	DR. KENT L. MCLEOD
Credential	:	DC
Telephone Number	:	414-223-4550

Provider Enumeration Date	:	01/19/2011
Last Update Date	:	08/25/2025

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