| Harris Family Chiropractic | |
|
123 N Broadway St, Stanley, WI 54768-1005 | |
| (715) 644-5677 | |
| (715) 644-3422 |
| Full Name | Harris Family Chiropractic |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 123 N Broadway St, Stanley, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649454562 | NPI | - | NPPES |
| 38785200 | Medicaid | WI | |
| 100027384 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 1937 012 (Wisconsin) | Secondary |
| 111N00000X | Chiropractor | 48-70-12 (Wisconsin) | Primary |
| 111N00000X | Chiropractor | 4906-12 (Wisconsin) | Secondary |
| Provider Name | Jennifer A Haas |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1275888778 PECOS PAC ID: 4981851961 Enrollment ID: I20120827000377 |
| Provider Name | Gregory Robert Haas |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043554561 PECOS PAC ID: 8820243280 Enrollment ID: I20130311000057 |
| Mailing Address | Practice Location Address |
|---|---|
| Harris Family Chiropractic 123 N Broadway St, Stanley, WI 54768-1005 Ph: (715) 644-5677 | Harris Family Chiropractic 123 N Broadway St, Stanley, WI 54768-1005 Ph: (715) 644-5677 |
Dr. Dalton Russell Lewallen, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 9520 County Highway H, Stanley, WI 54768 Phone: 715-644-5428 | |
Dr. Gregory Robert Haas, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 123 N Broadway St, Stanley, WI 54768 Phone: 715-644-5677 | |
Dr. Jennifer Ann Haas, D.C., MSHS Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 123 N Broadway St, Stanley, WI 54768 Phone: 715-644-5677 Fax: 715-644-3422 | |
Dr. Todd Ponick, DC Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 9520 County Highway H, Stanley, WI 54768 Phone: 715-644-5428 Fax: 715-644-5486 | |
Ponick Chiropractic Chiropractor Medicare: Medicare Enrolled Practice Location: 9520 County Highway H, Stanley, WI 54768 Phone: 715-644-5428 Fax: 715-644-5486 |