| Puckette Chiropractic & Kinesiology, S.c. | |
|
5712 Odana Rd Madison WI 53719-1221 | |
| (608) 276-7635 | |
| Not Available |
| Full Name | Puckette Chiropractic & Kinesiology, S.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 5712 Odana Rd, Madison, Wisconsin |
| Authorized Official Name and Position | Steven R. Puckette (OWNER) |
| Authorized Official Contact | 6082767635 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Puckette Chiropractic & Kinesiology, S.c. 5712 Odana Rd Madison WI 53719-1221 Ph: (608) 276-7635 | Puckette Chiropractic & Kinesiology, S.c. 5712 Odana Rd Madison WI 53719-1221 Ph: (608) 276-7635 |
| NPI Number | 1861519159 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 6305084674 |
|---|---|
| Medicare Enrollment ID | O20130528000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861519159 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3198 (Wisconsin) | Primary |
| Provider Name | Steven R Puckette |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811905565 PECOS PAC ID: 9830337104 Enrollment ID: I20130528000239 |
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