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General NPI Number Information
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NPI Number | 1073790028
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Entity Type | Organization
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Legal Business Name | WISEMAN CHIROPRACTIC WELLNESS CENTER P.C.
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 1863 W A ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-4534
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Country | US
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Telephone | 308-532-3536
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Fax |
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Provider Business Mailing Address
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Address Line | 1863 W A ST
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City | NORTH PLATTE
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State | NE
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Zip | 69101-4534
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DR OF CHIROPRACTIC
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Name | DR. DAWN R WISEMAN
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Credential |
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Telephone | 308-532-3536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1261
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License Number State | NE
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