Organization · NPI-2

360 Wellness LLC

Chiropractor · Madison, WI

NPI number1376168989
StatusActive
Last updated in NPPESJun 9, 2020

Details

NPI
1376168989
Entity type
Organization (NPI-2)
Legal business name
360 Wellness LLC
Organization subpart
No
Enumeration date
Jun 9, 2020
Certification date
Jun 9, 2020
Last updated
Jun 9, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor––Yes
225100000X Physical Therapist––

Other names

  • 360 Wellness Chiropractic & Physical Therapy (Doing Business As)

Practice location

504 S Yellowstone Lane
Madison, WI 53719

Phone 847-558-9155

Mailing address

504 S Yellowstone Lane
Madison, WI 53719

Phone 847-558-9155

Authorized official

Nathan James Andersen
Co-Owner
8475589155

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