| |
911 Milwaukee Ave, Suite A, South Milwaukee, WI 53172-2117 | |
(414) 762-5775 | |
(414) 762-5895 |
Full Name | |
---|---|
Type | Facility |
Speciality | Acupuncturist |
Location | 911 Milwaukee Ave, South Milwaukee, Wisconsin |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1396097762 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | 454055 (Wisconsin) | Primary |
Mailing Address | Practice Location Address |
---|---|
911 Milwaukee Ave, Suite A, South Milwaukee, WI 53172-2117 Ph: (414) 762-5775 | 911 Milwaukee Ave, Suite A, South Milwaukee, WI 53172-2117 Ph: (414) 762-5775 |
Mr. Loran Ezra Dowling Jr., MSOM Acupuncturist Medicare: Not Enrolled in Medicare Practice Location: 911 Milwaukee Ave, Suite A, South Milwaukee, WI 53172 Phone: 414-762-5775 Fax: 414-762-5895 |