| NPI | 1801076872 |
|---|---|
| Other Name | CREEKSIDE CHIROPRACTIC |
| Entity Type | Organization |
| Authorized Contact | ANDREW L TISLAU Chiropractor 920-459-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WI 4549-12) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 4058-012) |
| 111N00000X Chiropractor (Licence: WI 2308-12) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2024-02-08 |