| Elite Sport & Spine, Llc | |
|
1375 S Cherokee Dr, Waukesha, WI 53186-5343 | |
| (920) 723-5197 | |
| Not Available |
| Full Name | Elite Sport & Spine, Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1375 S Cherokee Dr, Waukesha, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053740803 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4968-12 (Wisconsin) | Primary |
| Provider Name | Zacharias A Shiels |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568891497 PECOS PAC ID: 5799913257 Enrollment ID: I20140109000170 |
| Provider Name | Moira Martin |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1891202032 PECOS PAC ID: 1658632120 Enrollment ID: I20180223002100 |
| Provider Name | Adam Cosson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1912408246 PECOS PAC ID: 1052665544 Enrollment ID: I20181120001185 |
| Provider Name | Jay White |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1891447447 PECOS PAC ID: 8224408752 Enrollment ID: I20221228000482 |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Sport & Spine, Llc 1375 S Cherokee Dr, Waukesha, WI 53186-5343 Ph: (920) 723-5197 | Elite Sport & Spine, Llc 1375 S Cherokee Dr, Waukesha, WI 53186-5343 Ph: (920) 723-5197 |
Dr. Ryan Michael Hetzel, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1720 Dolphin Ct, Suite E, Waukesha, WI 53186 Phone: 262-547-7441 Fax: 262-547-1971 | |
Edwards Chiropractic Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 21195 Watertown Rd, Waukesha, WI 53186 Phone: 414-784-3277 Fax: 262-784-1957 | |
Heather Davidson, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 21075 Swenson Drive Suite 700, Waukesha, WI 53186 Phone: 262-754-6850 | |
Dr. Breyan Michelle Radeck, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 2717 N Grandview Blvd Ste 101, Waukesha, WI 53188 Phone: 262-349-9370 Fax: 262-349-9729 | |
Breyan Radeck Dc, Llc Chiropractor Medicare: Medicare Enrolled Practice Location: 2717 N Grandview Blvd Ste 101, Waukesha, WI 53188 Phone: 262-349-9370 Fax: 262-349-9729 | |
Wellness Way Waukesha Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 628 W Moreland Blvd, Waukesha, WI 53188 Phone: 262-650-0701 |