Organization
WISCONSIN PAIN & REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD JASON SUSSMAN DC (OWNER)
(305) 608-9248
Entity
Organization
Contact information
Practice address
2100 N MAYFAIR RD, 201, WAUWATOSA, WI 53226-2239
(305) 608-9248
Mailing address
1670 ISLAND WAY, WESTON, FL 33326-3624
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH7456
FL
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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