Foundations Chiropractic Llc | |
W502 Spur Ln, Fountain City, WI 54629-7208 | |
(815) 275-4271 | |
Not Available |
Full Name | Foundations Chiropractic Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | W502 Spur Ln, Fountain City, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1750783775 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 5041-12 (Wisconsin) | Primary |
Provider Name | Kyle W Grimes |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1285070664 PECOS PAC ID: 9638318561 Enrollment ID: I20141229000368 |
Provider Name | Samantha Grimes |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1457725285 PECOS PAC ID: 8527380757 Enrollment ID: I20151124001029 |
Mailing Address | Practice Location Address |
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Foundations Chiropractic Llc S3192 Brandhorst Rd, Fountain City, WI 54629-7402 Ph: (815) 275-4271 | Foundations Chiropractic Llc W502 Spur Ln, Fountain City, WI 54629-7208 Ph: (815) 275-4271 |
Kyle William Grimes, D.C. Chiropractor Medicare: May Accept Medicare Assignments Practice Location: W502 Spur Ln, Fountain City, WI 54629 Phone: 608-687-1255 Fax: 608-687-1255 | |
Mrs. Samantha Grimes, D.C. Chiropractor Medicare: Medicare Enrolled Practice Location: W502 Spur Ln, Fountain City, WI 54629 Phone: 608-687-1255 Fax: 608-687-1255 |