NPI | 1306102066 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA RENEE THIELE Owner/Chiropractor 920-327-3752 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 4371-012) |
Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: WI 5028) |
Enumeration Date | 2012-04-06 |
Last Update Date | 2012-04-06 |