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General NPI Number Information
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NPI Number | 1467695650
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Entity Type | Organization
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Legal Business Name | PRICE CHIROPRACTIC SERVICES, LLC
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 12/11/2009
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Provider Practice Location Address
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Address Line | 2723 S 108TH ST
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City | WEST ALLIS
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State | WI
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Zip | 53227-3232
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Country | US
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Telephone | 414-763-4673
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Fax | 414-763-4924
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Provider Business Mailing Address
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Address Line | 2723 S 108TH ST
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City | WEST ALLIS
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State | WI
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Zip | 53227-3232
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Country | US
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Telephone | 414-763-4673
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Fax | 414-763-4924
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. KENNETH ELON PRICE
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Credential | D.C.
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Telephone | 414-763-4673
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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 | 4434-012
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License Number State | WI
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