| NPI | 1780774760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE D SKOGMAN Treasurer 920-288-8383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 2576) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 2216) |
| 111N00000X Chiropractor (Licence: WI 3140) | |
| 111N00000X Chiropractor (Licence: WI 2312) | |
| 111NN0400X Chiropractor, Neurology (Licence: WI 1783) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2020-08-22 |