Organization
INNATE LIFE LLC
Active
Other names
Innate Life
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY MILCAREK DC (OWNER)
(715) 453-5365
Entity
Organization
Contact information
Practice address
1338 N 4TH ST, TOMAHAWK, WI 54487-2137
(171) 545-3536
Mailing address
PO BOX 351, TOMAHAWK, WI 54487-0351
(171) 545-3536
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255868550
—
WI
Enumeration date
01/03/2023
Last updated
09/25/2023
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