Individual
CHANDRA ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.M.T./H.L.P/M.E.
Contact information
Practice address
6330 W NORTH AVE, WAUWATOSA, WI 53213-2051
(415) 258-2476
Mailing address
6330 W NORTH AVE, WAUWATOSA, WI 53213-2051
(414) 258-2476
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
52167-82
WI
225700000X
Massage Therapist
Primary
3583-146
WI
225C00000X
Rehabilitation Counselor
102923
WA
Other
Enumeration date
06/26/2015
Last updated
08/24/2015
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