Northern Chiropractic And Wellness Llc | |
709 Dyer St, Crivitz, WI 54114-7480 | |
(715) 854-5025 | |
Not Available |
Full Name | Northern Chiropractic And Wellness Llc |
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Type | Facility |
Speciality | Chiropractor |
Location | 709 Dyer St, Crivitz, 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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1619427630 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 5160-12 (Wisconsin) | Primary |
Provider Name | Kellen J Blanck-grott |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1306200472 PECOS PAC ID: 4082902598 Enrollment ID: I20161017002543 |
Mailing Address | Practice Location Address |
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Northern Chiropractic And Wellness Llc Po Box 593, Crivitz, WI 54114-0593 Ph: (715) 854-5025 | Northern Chiropractic And Wellness Llc 709 Dyer St, Crivitz, WI 54114-7480 Ph: (715) 854-5025 |
Glen R Ledvina, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 107 N Highway 141, Crivitz, WI 54114 Phone: 715-854-7073 | |
Kellen Blanck-grott, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 709 Dyer St, Crivitz, WI 54114 Phone: 715-854-5025 | |
Brianna Blanck-grott, D.C. Chiropractor Medicare: Medicare Enrolled Practice Location: 709 Dyer St, Crivitz, WI 54114 Phone: 715-854-5025 Fax: 866-323-0252 |