Provider Demographics
NPI:1144577875
Name:KASTEN, MAGGIE MAY (DC)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:MAY
Last Name:KASTEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 E ESTATES PL
Mailing Address - Street 2:
Mailing Address - City:OAK CREEK
Mailing Address - State:WI
Mailing Address - Zip Code:53154-5122
Mailing Address - Country:US
Mailing Address - Phone:414-430-7005
Mailing Address - Fax:
Practice Address - Street 1:114 E GREENFIELD AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53204-2966
Practice Address - Country:US
Practice Address - Phone:414-220-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5382-12111N00000X
IL038011941111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5382-12OtherPROVIDER LICENSE #
IL038011941OtherPROVIDER LICENSE #