Organization
MEDICAL ACUPUNCTURE & PAIN CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE VEGAFRIA MD (OWNER/PRESIDENT)
(262) 335-8025
Entity
Organization
Contact information
Practice address
422 MEADOWBROOK DR, WEST BEND, WI 53090-2416
(262) 335-8025
Mailing address
422 MEADOWBROOK DR, WEST BEND, WI 53090-2416
(262) 335-8025
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31208800
—
WI
Enumeration date
07/23/2006
Last updated
10/06/2011
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