| NPI | 1467755801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELDA FOSSO Chiropractor 920-230-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 3365012) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4026012) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2025-08-06 |