Healthcare Provider Details

I. General information

NPI: 1568367886
Provider Name (Legal Business Name): RADIANT HEALTH CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 9TH AVE
EAU CLAIRE WI
54703-5684
US

IV. Provider business mailing address

115 9TH AVE
EAU CLAIRE WI
54703-5684
US

V. Phone/Fax

Practice location:
  • Phone: 715-838-9432
  • Fax: 715-838-9435
Mailing address:
  • Phone: 715-838-9432
  • Fax: 715-838-9435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. TAMMY AMOTH
Title or Position: OWNER
Credential: D.C.
Phone: 715-838-9432