| Healthsource Of Bangor S C | |
|
1505 Commercial St, Bangor, WI 54614-0410 | |
| (608) 486-4899 | |
| (608) 486-4661 |
| Full Name | Healthsource Of Bangor S C |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1505 Commercial St, Bangor, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912167057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 2555 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Healthsource Of Bangor S C Po Box 410, Bangor, WI 54614-0410 Ph: (608) 486-4899 | Healthsource Of Bangor S C 1505 Commercial St, Bangor, WI 54614-0410 Ph: (608) 486-4899 |
Dr. Jack Anthony Manzella, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 1505 Commercial St., Bangor Family Chiropractic, Bangor, WI 54614 Phone: 608-486-4899 Fax: 608-486-4661 | |
Alexander Manzella, D.C. Chiropractor Medicare: Medicare Enrolled Practice Location: 1505 Commercial St, Bangor, WI 54614 Phone: 608-486-4899 Fax: 608-486-4661 |