Individual
DR. MICHAEL BRANDON ZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10532 N PORT WASHINGTON RD, MEQUON, WI 53092-5563
(262) 240-1600
(262) 240-1602
Mailing address
10532 N PORT WASHINGTON RD, MEQUON, WI 53092-5563
(262) 240-1600
(262) 240-1602
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4134-012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38967100
—
WI
Enumeration date
08/24/2006
Last updated
11/15/2008
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