MEDICARE: MILWAUKEE TOTAL HEALTH LLC

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

General Provider Information

NPI Number	:	1952653107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILWAUKEE TOTAL HEALTH LLC

Provider Business Mailing Address
First Line	:	N63W23524 SILVER SPRING DR STE 4
Second Line	:
City	:	SUSSEX
State	:	WI
Zip	:	53089-3833
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	N63W23524 SILVER SPRING DR STE 4
Second Line	:
City	:	SUSSEX
State	:	WI
Zip	:	53089-3833
Country	:	US
Telephone Number	:	262-246-0093
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	DR. THOMAS PAUL SMITH
Credential	:	D.C.
Telephone Number	:	262-246-0093

Provider Enumeration Date	:	10/12/2012
Last Update Date	:	10/12/2012

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