Individual
CHARLES DANE HOLLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
4813 W NATIONAL AVE, MILWAUKEE, WI 53214-3523
(414) 502-8235
(414) 921-9772
Mailing address
S30W30370 SUNSET DR, WAUKESHA, WI 53189-9007
(229) 733-7980
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1041-55
WI
Other
Enumeration date
01/26/2022
Last updated
04/19/2023
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