Healthcare Provider Details

I. General information

NPI: 1841489028
Provider Name (Legal Business Name): PROCARE CHIROPRACTIC S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 S SAINT JOSEPH AVE STE 2
ARCADIA WI
54612-1439
US

IV. Provider business mailing address

308 S SAINT JOSEPH AVE STE 2
ARCADIA WI
54612-1439
US

V. Phone/Fax

Practice location:
  • Phone: 608-323-8563
  • Fax:
Mailing address:
  • Phone: 608-323-8563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ALAN JEFFREY BASSUENER
Title or Position: OWNER
Credential: D.C.
Phone: 608-323-8563