Organization
INTERGRATED PAIN AND SPINE CARE SC
Active
Organization
INTERGRATED PAIN AND SPINE CARE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY KIRK (CREDENTIALING SPECIALIST)
(414) 967-9000
Entity
Organization
Contact information
Practice address
5261 N PORT WASHINGTON RD STE 100, MILWAUKEE, WI 53217-4903
(414) 967-9000
(414) 332-3712
Mailing address
PO BOX 170181, GLENDALE, WI 53217-8016
(414) 967-9000
(414) 332-3712
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
3812-012
WI
Other
Enumeration date
10/10/2017
Last updated
06/20/2018
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