Healthcare Provider Details

I. General information

NPI: 1780774760
Provider Name (Legal Business Name): BAY CARE COMPLEMENTARY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2845 GREENBRIER RD
GREEN BAY WI
54311-6519
US

IV. Provider business mailing address

2845 GREENBRIER RD P O BOX 8900 SUITE 340
GREEN BAY WI
54311-6519
US

V. Phone/Fax

Practice location:
  • Phone: 920-288-8383
  • Fax: 920-288-8385
Mailing address:
  • Phone: 920-288-8383
  • Fax: 920-288-8385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2576
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2216
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3140
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number1783
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2312
License Number StateWI

VIII. Authorized Official

Name: DR. WADE D SKOGMAN
Title or Position: TREASURER
Credential: DC
Phone: 920-288-8383