Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 1550024 | WI |
NPI | 1295894640 |
---|---|
Provider Name | Mrs. Rae Jean Muchenberger |
First Address | New Berlin, WI 53151-7545 |
Second Address | West Allis, WI 53227-1628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 08/07/2007 |