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General NPI Number Information
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NPI Number | 1689988495
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Entity Type | Organization
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Legal Business Name | CODY HANSEN CHIROPRACTIC LLC
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Dates
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Enumeration Date | 08/04/2010
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 2114 SCHOFIELD AVE
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City | WESTON
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State | WI
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Zip | 54476-2365
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Country | US
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Telephone | 715-355-4224
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Fax | 715-355-4120
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Provider Business Mailing Address
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Address Line | 2114 SCHOFIELD AVE
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City | WESTON
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State | WI
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Zip | 54476-2365
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Country | US
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Telephone | 715-355-4224
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Fax | 715-355-4120
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Authorized Official
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Title or Position | OWNER
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Name | CODY J HANSEN
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Credential | DC
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Telephone | 715-355-4224
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3727
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License Number State | WI
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