| Ideal Human Llc | |
|
N64w24801 Main St Ste 119, Sussex, WI 53089-2652 | |
| (262) 312-4075 | |
| Not Available |
| Full Name | Ideal Human Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | N64w24801 Main St Ste 119, Sussex, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285589143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Stephen Philippe Moreau |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1902256498 PECOS PAC ID: 7911473046 Enrollment ID: I20260416002568 |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Human Llc N64w24801 Main St Ste 119, Sussex, WI 53089-2652 Ph: (262) 312-4075 | Ideal Human Llc N64w24801 Main St Ste 119, Sussex, WI 53089-2652 Ph: (262) 312-4075 |
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