Individual
ROBERT WILLIAM MICLOT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
17495 W CAPITOL DR, BROOKFIELD, WI 53045
(262) 790-4900
(262) 790-4900
Mailing address
8216 N 38TH ST, BROWN DEER, WI 53209
(414) 362-0880
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2689
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38865700
—
WI
Enumeration date
09/26/2006
Last updated
07/08/2007
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