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Individual

GRANT KEITH RADERMACHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
16620 W BLUEMOUND RD, BROOKFIELD, WI 53005-5966
(262) 345-4166
Mailing address
16620 W BLUEMOUND RD, BROOKFIELD, WI 53005-5966
(262) 345-4166

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4707
WI

Other

Enumeration date
09/10/2017
Last updated
07/21/2022
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