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General NPI Number Information
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NPI Number | 1114452091
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Entity Type | Organization
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Legal Business Name | NORTH POINT CHIROPRACTIC LLC
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Dates
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Enumeration Date | 04/27/2017
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 21150 CAPITOL DR SUITE 5
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City | BROOKFIELD
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State | WI
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Zip | 53072-2911
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Country | US
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Telephone | 414-482-5282
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Fax |
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Provider Business Mailing Address
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Address Line | 21150 W CAPITOL DR STE 5
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City | BROOKFIELD
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State | WI
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Zip | 53072-2913
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Country | US
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Telephone | 414-482-5282
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Fax | 414-877-1409
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | VICTORIA SANDSTROM GONZALEZ
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Credential | DC
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Telephone | 414-482-5282
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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 | 5272-12
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License Number State | WI
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