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Individual

BRADLEY L KEES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
113 SHERMAN AVE W, FORT ATKINSON, WI 53538-1732
(920) 563-2281
Mailing address
601 S 32ND AVE, WAUSAU, WI 54401-3958
(715) 848-2526

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3603-012
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38920000
WI
01
38993900
MEDICAID GROUP
WI
Enumeration date
09/15/2006
Last updated
12/18/2007
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