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General NPI Number Information
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NPI Number | 1760713051
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Entity Type | Organization
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Legal Business Name | ABUNDANT HEALTH CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 1804 S ASHLAND AVE
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City | GREEN BAY
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State | WI
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Zip | 54304-3702
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Country | US
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Telephone | 920-405-9830
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Fax |
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Provider Business Mailing Address
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Address Line | 1804 S ASHLAND AVE
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City | GREEN BAY
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State | WI
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Zip | 54304-3702
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Country | US
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Telephone | 920-405-9830
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PATRICIA ANN RINDY
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Credential | DC
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Telephone | 920-405-9830
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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 | 3381-012
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License Number State | WI
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