Individual
SHANE SLAASTED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
10101 W WISCONSIN AVE, MILWAUKEE, WI 53226-4861
(414) 259-6310
Mailing address
10101 W WISCONSIN AVE, MILWAUKEE, WI 53226, MILWAUKEE, WI 53226
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2954-19
WI
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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