Provider Demographics
NPI:1588733083
Name:MICHALSKI, RONALD THADEUS (DC, FACO, DABCO)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:THADEUS
Last Name:MICHALSKI
Suffix:
Gender:M
Credentials:DC, FACO, DABCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11407 W BLUEMOUND RD
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-4031
Mailing Address - Country:US
Mailing Address - Phone:414-778-1900
Mailing Address - Fax:414-778-1759
Practice Address - Street 1:11407 W BLUEMOUND RD
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-4031
Practice Address - Country:US
Practice Address - Phone:414-778-1900
Practice Address - Fax:414-778-1759
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2015-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI551157111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000175698Medicare PIN
WIT62765Medicare UPIN