| The Center For Human Restoration, Inc | |
|
505 W Glen St Ste 1 Crandon WI 54520-1356 | |
| (715) 478-5202 | |
| (715) 478-5205 |
| Full Name | The Center For Human Restoration, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 505 W Glen St Ste 1, Crandon, Wisconsin |
| Authorized Official Name and Position | Laura Jean Connor (PRESIDENT) |
| Authorized Official Contact | 7154785202 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Center For Human Restoration, Inc Po Box 39 Crandon WI 54520-0039 Ph: (715) 478-5202 | The Center For Human Restoration, Inc 505 W Glen St Ste 1 Crandon WI 54520-1356 Ph: (715) 478-5202 |
| NPI Number | 1740561521 |
|---|---|
| Provider Enumeration Date | 09/07/2011 |
| Last Update Date | 03/30/2022 |
| Medicare PECOS PAC ID | 2365603479 |
|---|---|
| Medicare Enrollment ID | O20120417000854 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740561521 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4632-012 (Wisconsin) | Primary |
| Provider Name | Laura J Connor |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1528348133 PECOS PAC ID: 2264696806 Enrollment ID: I20120612000540 |
| Provider Name | Dakota Ann Malzewski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811554991 PECOS PAC ID: 9133453210 Enrollment ID: I20190624001443 |
Sokaogon Chippewa Community Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3144 Vanzile Rd, Crandon, WI 54520 Phone: 715-478-5180 Fax: 715-478-5904 | |
Northwoods Behavioral Health Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 W Broad St, Crandon, WI 54520 Phone: 920-217-7910 |