Provider Demographics
NPI:1487932331
Name:FRITZ, JOSHUA PAUL (DC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:PAUL
Last Name:FRITZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 S KINNICKINNIC AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53207-2936
Mailing Address - Country:US
Mailing Address - Phone:414-295-6045
Mailing Address - Fax:
Practice Address - Street 1:3116 S KINNICKINNIC AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53207-2936
Practice Address - Country:US
Practice Address - Phone:414-295-6045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4761-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor