Individual
JESSE FOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSOM, L.AC.
Contact information
Practice address
4040 N CALHOUN RD, BROOKFIELD, WI 53005-1336
(262) 901-0053
Mailing address
1060 N 115TH ST APT 305, WAUWATOSA, WI 53226-3446
(414) 254-0223
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
435055
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11634122
CAQH PROVIDER NUMBER
WI
Enumeration date
12/01/2006
Last updated
07/08/2007
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