Individual
MICHAEL LAWRENCE ZASTROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2920 S WEBSTER AVE, SUITE B, GREEN BAY, WI 54301-1594
(920) 339-9774
(920) 339-9764
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526
(715) 848-2225
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1813-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38777600
—
WI
01
—
38998500
MEDICAID CLINIC NUMBER
WI
Enumeration date
05/19/2006
Last updated
12/19/2007
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