Individual
NICHOLAS AGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17585 GOLF PKWY, BROOKFIELD, WI 53045-2948
(262) 899-7158
Mailing address
17585 GOLF PKWY, BROOKFIELD, WI 53045-2948
(262) 899-7158
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5715-12
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295378875
—
WI
Enumeration date
01/24/2022
Last updated
01/26/2022
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