| Countryview Chiropractic Clinic, S.c. | |
|
W5675 Cty Hwy B, Shawano, WI 54166-0060 | |
| (715) 526-6158 | |
| (715) 526-6178 |
| Full Name | Countryview Chiropractic Clinic, S.c. |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | W5675 Cty Hwy B, Shawano, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316095185 | NPI | - | NPPES |
| 38982000 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Kathryn J Mead |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1750588513 PECOS PAC ID: 1254422777 Enrollment ID: I20070813000076 |
| Provider Name | Kristina T Sipple |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1750549556 PECOS PAC ID: 8022183979 Enrollment ID: I20080812000733 |
| Provider Name | Sharon B Balstad |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548252257 PECOS PAC ID: 0446374243 Enrollment ID: I20100831000824 |
| Provider Name | Tyler Jerome Pensis |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043772346 PECOS PAC ID: 4082956735 Enrollment ID: I20190429000791 |
| Provider Name | Alexander Anton Provost |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1306434337 PECOS PAC ID: 7113331927 Enrollment ID: I20210205000686 |
| Mailing Address | Practice Location Address |
|---|---|
| Countryview Chiropractic Clinic, S.c. Po Box 60, Shawano, WI 54166-0060 Ph: (715) 526-6158 | Countryview Chiropractic Clinic, S.c. W5675 Cty Hwy B, Shawano, WI 54166-0060 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 | |
Alexander Anton Provost, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: W5675 County Road B, Shawano, WI 54166 Phone: 715-526-6158 | |
Verkuilen Family Chiropractic, Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 154 Woodlawn Dr, Shawano, WI 54166 Phone: 715-524-6720 Fax: 715-524-5581 | |
Brosnan Chiropractic, Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 322 E Green Bay St, Shawano, WI 54166 Phone: 715-526-5019 Fax: 715-524-9977 |