| 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 |