Alexander Anton Provost, DC | |
W5675 County Road B, Shawano, WI 54166-6901 | |
(715) 526-6158 | |
Not Available |
Full Name | Alexander Anton Provost |
---|---|
Gender | Male |
Speciality | Chiropractic |
Experience | 5 Years |
Location | W5675 County Road B, Shawano, Wisconsin |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306434337 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 6646 (Minnesota) | Secondary |
111N00000X | Chiropractor | 5599-12 (Wisconsin) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Countryview Chiropractic Clinic Sc | 7810088333 | 5 |
Provider Name | Countryview Chiropractic Clinic Sc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1316095185 PECOS PAC ID: 7810088333 Enrollment ID: O20070813000052 |
Mailing Address | Practice Location Address |
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Alexander Anton Provost, DC 8732 Polk St Ne, Blaine, MN 55434-2346 Ph: (763) 439-6576 | Alexander Anton Provost, DC W5675 County Road B, Shawano, WI 54166-6901 Ph: (715) 526-6158 |
Dr. Tyler Pensis, Chiropractor Medicare: Accepting Medicare Assignments Practice Location: W5675 Cty Hwy B, Shawano, WI 54166 Phone: 715-526-6158 | |
Dr. Michael E Brosnan, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 322 E Green Bay St, Shawano, WI 54166 Phone: 715-526-5019 | |
Dr. Aeric Berner, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 153 S Main St, Shawano, WI 54166 Phone: 715-201-1081 Fax: 715-350-6767 | |
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