| Chiropractic And Wellness On Pewaukee Lake | |
|
213 W Wisconsin Ave, Pewaukee, WI 53072-3435 | |
| (262) 695-0022 | |
| (262) 695-0011 |
| Full Name | Chiropractic And Wellness On Pewaukee Lake |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 213 W Wisconsin Ave, Pewaukee, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104031764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 3967-012 (Wisconsin) | Primary |
| Provider Name | Tad A Diciaula |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124181680 PECOS PAC ID: 2466353750 Enrollment ID: I20040120000055 |
| Provider Name | Bradley William Nutting |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1558536185 PECOS PAC ID: 7618048810 Enrollment ID: I20080616000545 |
| Mailing Address | Practice Location Address |
|---|---|
| Chiropractic And Wellness On Pewaukee Lake 213 W Wisconsin Ave, Pewaukee, WI 53072-3435 Ph: (262) 695-0022 | Chiropractic And Wellness On Pewaukee Lake 213 W Wisconsin Ave, Pewaukee, WI 53072-3435 Ph: (262) 695-0022 |
Tara Marie Gill, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: N35w23770 Capitol Dr, Pewaukee, WI 53072 Phone: 262-695-1870 Fax: 262-695-1872 | |
The Chiropractors, Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 690 Westfield Way Ste F, Pewaukee, WI 53072 Phone: 262-691-0997 Fax: 262-875-3593 | |
Dr. Erin Elizabeth Nash, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 2343 Silvernail Rd, Pewaukee, WI 53072 Phone: 262-548-9000 Fax: 262-548-8155 | |
Dr. Tad Alan Diciaula, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 213 W Wisconsin Ave, Pewaukee, WI 53072 Phone: 262-695-0022 Fax: 262-695-0011 | |
Marc Eliszewski, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 1300 Capitol Dr Ste E, Pewaukee, WI 53072 Phone: 262-650-0701 Fax: 262-650-8101 | |
Dr. Katelyn Ann Dawson, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: N35w23770 Capitol Dr, Pewaukee, WI 53072 Phone: 262-695-1870 |