# MILWAUKEE SPINE AND JOINT CENTER

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

## Provider details

- **NPI number:** 1821333550
- **Authorized official:** DR. KELLY WORTH D.C. (CHIROPRACTOR-CLINIC DIRECTOR)
- **Authorized official phone:** (414) 643-9000

## Contact information

- **Practice address:** 1631 W LINCOLN AVE, MILWAUKEE, WI 53215-2637
- **Practice address phone:** (414) 643-9000
- **Practice address fax:** (414) 643-9004
- **Mailing address:** 1631 W LINCOLN AVE, MILWAUKEE, WI 53215-2637
- **Mailing address phone:** (414) 643-9000
- **Mailing address fax:** (414) 643-9004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 4264-012 | WI | Yes |

## Other

- **Enumeration date:** 12/06/2012
- **Last updated:** 12/06/2012