| NPI | 1467503656 |
|---|---|
| Doing Business As | UNITED CHIROPRACTIC SPORTS & REHA |
| Entity Type | Organization |
| Authorized Contact | TODD PHILIP MORTENSEN Clinic Director And Owner 262-723-3235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 3859-012) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: MN 4229) |
| 111N00000X Chiropractor (Licence: IL 38010724) | |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2011-02-07 |