| NPI | 1093218745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KALLIE ANN MADISON Chiropractor 920-336-3353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 5115-12) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 5112-12) |
| Enumeration Date | 2018-03-08 |
| Last Update Date | 2018-06-16 |