| NPI | 1255701496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY S WAKEFIELD Owner 715-762-2950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 2521-012) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: WI 3939-24) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2016-12-20 |