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General NPI Number Information
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NPI Number | 1861059313
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Entity Type | Organization
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Legal Business Name | WICKABOAG FAMILY CHIROPRACTIC INC
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Dates
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Enumeration Date | 05/21/2019
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Last Update Date | 08/24/2024
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Provider Practice Location Address
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Address Line | 143 W MAIN ST
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City | W BROOKFIELD
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State | MA
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Zip | 01585-2812
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Country | US
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Telephone | 508-867-6161
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Fax | 508-867-1961
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Provider Business Mailing Address
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Address Line | PO BOX 168
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City | WEST BROOKFIELD
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State | MA
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Zip | 01585-0168
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Country | US
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Telephone | 508-867-6161
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Fax | 508-867-1961
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LINDA SCHAETZKE
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Credential | DC
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Telephone | 508-867-6161
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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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