Lake Delton Chiropractic Clinic LLC
Chiropractor in Wisconsin Dells, WI. Organization (NPI-2).
NPI number1619087871
StatusActive
Last updated in NPPESMay 17, 2019
Details
- NPI
- 1619087871
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Delton Chiropractic Clinic LLC
- Organization subpart
- No
- Enumeration date
- Aug 30, 2006
- Last updated
- May 17, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 4029-012 | WI | Yes |
Other names
- Healthsource Chiropractic & Progressive Wellness (Doing Business As)
Practice location
151 Wisconsin Dells Pkwy SWisconsin Dells, WI 53965
Phone 608-253-0102 · Fax 608-253-0188
Mailing address
151 Wisconsin Dells Pkwy SWisconsin Dells, WI 53965
Phone 608-253-0102 · Fax 608-253-0188
Authorized official
Todd Joseph Bauer
Owner
6086979994
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Other Chiropractor providers in Wisconsin Dells, WI
- Todd Joseph Bauer, D.C.NPI 1609981380
- Diana Marshall Fedewa, D.C.NPI 1417165473
- Duane Michael Fedewa, D.C.NPI 1962610949
- Joseph Chiropractic ScNPI 1720280522
- Daniel Edward Joseph, D.C.NPI 1821199506
All 6 Chiropractor providers in Wisconsin Dells · All 87 providers in Wisconsin Dells
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