# KINETIC SPINE AND PAIN SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013738509
- **Authorized official:** OSCAR C WILLE MD (PRESIDENT & CEO)
- **Authorized official phone:** (414) 232-7268

## Contact information

- **Practice address:** 4491 N OAKLAND AVE, SHOREWOOD, WI 53211-1611
- **Practice address phone:** (414) 999-3815
- **Mailing address:** 4491 N OAKLAND AVE, SHOREWOOD, WI 53211-1611
- **Mailing address phone:** (414) 999-3815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2024
- **Last updated:** 11/27/2024