Organization
REISWIG AESTHETICS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA REISWIG M.D. (OWNER/PHYSICIAN)
(414) 526-1291
Entity
Organization
Contact information
Practice address
1233 N MAYFAIR RD STE 208, WAUWATOSA, WI 53226-3255
(414) 526-1291
Mailing address
1233 N MAYFAIR RD STE 208, WAUWATOSA, WI 53226-3255
(414) 526-1291
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
52720-20
WI
Other
Enumeration date
01/24/2014
Last updated
04/03/2014
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