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Individual

MICHAEL S MCKINNIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
8619 S HOWELL AVE, OAK CREEK, WI 53154-2919
(414) 856-1888
(414) 727-5779
Mailing address
PO BOX 11327, SHOREWOOD, WI 53211-0327
(414) 856-1888
(414) 727-5779

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3962
WI

Other

Enumeration date
06/20/2011
Last updated
06/20/2011
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