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General NPI Number Information
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NPI Number | 1508232125
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Entity Type | Organization
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Legal Business Name | RISING HEALTH CHIROPRACTIC WELLNESS CORP
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 601 RYAN ST SUITE F
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City | PEWAUKEE
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State | WI
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Zip | 53072-1844
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Country | US
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Telephone | 262-695-9698
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Fax | 262-695-0144
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Provider Business Mailing Address
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Address Line | 601 RYAN ST SUITE F
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City | PEWAUKEE
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State | WI
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Zip | 53072-1844
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Country | US
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Telephone | 262-695-9698
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Fax | 262-695-0144
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. JAMES MICHAEL HAUKE
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Credential | DC
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Telephone | 262-695-9698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3975-012
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License Number State | WI
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