Organization
THOMAS R. MARCINIAK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R MARCINIAK D.P.M. (OWNER)
(414) 546-4151
Entity
Organization
Contact information
Practice address
3515 S 68TH ST, MILWAUKEE, WI 53220-1206
(414) 546-4151
Mailing address
3515 S 68TH ST, MILWAUKEE, WI 53220-1206
(414) 546-4151
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
WI 461-25
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43217100
—
WI
Enumeration date
02/05/2008
Last updated
02/05/2008
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