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General NPI Number Information
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NPI Number | 1689848814
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Entity Type | Organization
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Legal Business Name | APEX FAMILY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 04/18/2008
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 210 E O'CONNOR DR SUITE 105
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City | ELKHORN
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State | WI
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Zip | 53121-0000
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Country | US
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Telephone | 262-723-2739
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Fax |
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Provider Business Mailing Address
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Address Line | 210 E O'CONNOR DR SUITE 105
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City | ELKHORN
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State | WI
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Zip | 53121-0000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. HEATHER DAWN DALTON
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Credential |
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Telephone | 262-723-2739
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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 | 4048-012
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License Number State | WI
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