Organization
ASPIRE WELLNESS & LIFESTYLE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY E GILSOUL C.AC, MSOM (ACUPUNCTURIST)
(262) 478-0030
Entity
Organization
Contact information
Practice address
216 GREEN BAY RD, SUITE 109, THIENSVILLE, WI 53092-1658
(262) 478-0030
Mailing address
216 GREEN BAY RD, SUITE 109, THIENSVILLE, WI 53092-1658
(262) 478-0030
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
674-55
WI
Other
Enumeration date
04/10/2013
Last updated
04/10/2013
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