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General NPI Number Information
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NPI Number | 1811185580
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Entity Type | Organization
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Legal Business Name | HEALING HANDS CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 5318 1ST AVE
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City | PITTSVILLE
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State | WI
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Zip | 54466-9566
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Country | US
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Telephone | 715-213-9277
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Fax | 715-884-2513
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Provider Business Mailing Address
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Address Line | 5318 1ST AVE PO BOX 274
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City | PITTSVILLE
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State | WI
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Zip | 54466-9566
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Country | US
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Telephone | 715-213-9277
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Fax | 715-884-2513
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. AMANDA S FOX
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Credential | DC
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Telephone | 715-213-9277
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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 | 4283-012
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License Number State | WI
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