| NPI | 1154838951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M. TENOLD Owner/VP 715-833-8777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 3815-33) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 2095-12) |
| 111N00000X Chiropractor (Licence: WI 4744-012) | |
| 111NR0400X Chiropractor, Rehabilitation (Licence: WI 2613-12) | |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |