Provider Demographics
NPI:1184857088
Name:ASSOCIATES IN SPINAL RELIEF, S.C.
Entity Type:Organization
Organization Name:ASSOCIATES IN SPINAL RELIEF, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:KERWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-282-9001
Mailing Address - Street 1:8081 W LAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3712
Mailing Address - Country:US
Mailing Address - Phone:414-282-9001
Mailing Address - Fax:414-282-4140
Practice Address - Street 1:8081 W LAYTON AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-3712
Practice Address - Country:US
Practice Address - Phone:414-282-9001
Practice Address - Fax:414-282-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty