Healthcare Provider Details

I. General information

NPI: 1942499330
Provider Name (Legal Business Name): ALLIANCE WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2007
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 S CENTRAL AVE
MARSHFIELD WI
54449-2833
US

IV. Provider business mailing address

156 S CENTRAL AVE
MARSHFIELD WI
54449-2833
US

V. Phone/Fax

Practice location:
  • Phone: 715-384-9064
  • Fax: 715-387-6954
Mailing address:
  • Phone: 715-384-9064
  • Fax: 715-387-6954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARGARET MERTENS
Title or Position: PRESIDENT
Credential: D.C.
Phone: 715-384-9064