Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Spine Center of Wisconsin SC

Organization Medical Specialty Clinic/Center · NPI 1467561506

Spine Center of Wisconsin SC is a Medical Specialty Clinic/Center in Milwaukee, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
Specialties on file
3

Practice location Address checks out

2801 W Kinnickinnic River Pkwy Ste 355
Milwaukee, WI 53215-3695
Phone: (414) 235-3623
Fax: (414) 235-3623
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence 19042 (WI)
Radiology Clinic/Center Taxonomy 261QR0200X · Licence XM39276 (WI)
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1467561506
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Banach — Ofc Mgr · (414) 235-3623
NPI enumeratedAugust 30, 2006
Last updated in NPPESSeptember 18, 2008
Mailing addressPo Box 320695, Franklin, WI 53132

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