Individual
KEALY SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOM, CA, BS
Contact information
Practice address
890 W WINGRA DR, MADISON, WI 53715-1942
(414) 943-3036
Mailing address
890 W WINGRA DR, UNIT 102, MADISON, WI 53715-1942
(414) 943-3036
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
824
WI
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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