Provider Demographics
NPI:1881859619
Name:AEHL, MICHAEL JOHN (LMT, LAC, MSOM)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:AEHL
Suffix:
Gender:M
Credentials:LMT, LAC, MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 HILLSIDE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2165
Mailing Address - Country:US
Mailing Address - Phone:262-646-2123
Mailing Address - Fax:262-646-5615
Practice Address - Street 1:2725 HILLSIDE DR
Practice Address - Street 2:SUITE A
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2165
Practice Address - Country:US
Practice Address - Phone:262-646-2123
Practice Address - Fax:262-646-5615
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1017-046225700000X
WI308-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist