Individual
JAMES ARTHUR TACYSHYN-ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6508 W LINCOLN AVE, WEST ALLIS, WI 53219-2045
(414) 810-0009
Mailing address
6508 W LINCOLN AVE, WEST ALLIS, WI 53219-2045
(414) 810-0009
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
WI2869
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38868500
—
WI
01
—
P00203589
MEDICARE RAILROAD
WI
Enumeration date
08/13/2006
Last updated
07/08/2007
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