Healthcare Provider Details

I. General information

NPI: 1861059313
Provider Name (Legal Business Name): WICKABOAG FAMILY CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2019
Last Update Date: 08/24/2024
Certification Date: 08/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 W MAIN ST
W BROOKFIELD MA
01585-2812
US

IV. Provider business mailing address

PO BOX 168
WEST BROOKFIELD MA
01585-0168
US

V. Phone/Fax

Practice location:
  • Phone: 508-867-6161
  • Fax: 508-867-1961
Mailing address:
  • Phone: 508-867-6161
  • Fax: 508-867-1961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA SCHAETZKE
Title or Position: PRESIDENT
Credential: DC
Phone: 508-867-6161