Individual
DR. TINA M MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
5306 N PORT WASHINGTON RD, GLENDALE, WI 53217
(414) 332-0859
(414) 332-3991
Mailing address
5306 N PORT WASHINGTON RD, GLENDALE, WI 53217
(414) 332-0859
(414) 332-3991
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4017-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38952600
—
WI
01
—
391555906018
COMPCAREBLUE & BLUE CROSS
WI
01
—
7611702
AETNA
WI
Enumeration date
10/02/2006
Last updated
07/09/2007
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