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General NPI Number Information
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NPI Number | 1437494929
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Entity Type | Organization
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Legal Business Name | WELLNESS WAY CHIROPRACTIC
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Dates
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Enumeration Date | 12/10/2012
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 10335 W OKLAHOMA AVE SUITE 202
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City | MILWAUKEE
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State | WI
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Zip | 53227-4100
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Country | US
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Telephone | 262-384-0064
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Fax |
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Provider Business Mailing Address
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Address Line | N83W13600 FOND DU LAC AVE UNIT #221
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-8104
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Country | US
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Telephone | 262-384-0064
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINSAY WAY
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Credential | D.C.
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Telephone | 262-384-0064
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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 | 4716-012
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License Number State | WI
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