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General NPI Number Information
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NPI Number | 1548662943
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Entity Type | Organization
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Legal Business Name | ALPHA CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/17/2014
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Last Update Date | 09/17/2014
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Provider Practice Location Address
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Address Line | 17 W SPRING ST
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-2183
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Country | US
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Telephone | 715-720-7116
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Fax | 715-720-7118
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Provider Business Mailing Address
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Address Line | 17 W SPRING ST
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City | CHIPPEWA FALLS
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State | WI
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Zip | 54729-2183
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Country | US
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Telephone | 715-720-7116
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Fax | 715-720-7118
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | MR. NATHAN JOHN MEYER
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Credential | D.C.
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Telephone | 715-720-7116
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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 | 3488
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License Number State | WI
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