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General NPI Number Information
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NPI Number | 1669151171
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Entity Type | Organization
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Legal Business Name | BREIDENBACH PRAIRIE VIEW CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | N5560 COUNTY ROAD ZM
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City | ONALASKA
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State | WI
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Zip | 54650-1300
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Country | US
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Telephone | 608-779-5323
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Fax | 608-402-6410
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Provider Business Mailing Address
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Address Line | N5560 COUNTY ROAD ZM
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City | ONALASKA
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State | WI
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Zip | 54650-1300
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Country | US
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Telephone | 608-779-5323
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY KAY BREIDENBACH
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Credential | DC, DICCP
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Telephone | 608-779-5323
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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 |
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License Number State |
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