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General NPI Number Information
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NPI Number | 1245378660
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Entity Type | Organization
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Legal Business Name | PACE CHIROPRACTIC OFFICE SC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 128 EAST 2ND STREET
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City | WESTFIELD
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State | WI
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Zip | 53964-0095
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Country | US
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Telephone | 608-296-2717
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Fax | 608-296-2643
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Provider Business Mailing Address
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Address Line | PO BOX 95
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City | WESTFIELD
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State | WI
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Zip | 53964-0095
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Country | US
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Telephone | 608-296-2717
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Fax | 608-296-2643
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MR. DARRELL J WRIGHT
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Credential |
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Telephone | 608-296-2717
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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 | 304012
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 219912
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License Number State | WI
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