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General NPI Number Information
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NPI Number | 1861832743
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Entity Type | Organization
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Legal Business Name | THROM HEALTH AND WELLNESS
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Dates
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Enumeration Date | 06/25/2013
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Last Update Date | 06/25/2013
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Provider Practice Location Address
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Address Line | 605 S 24TH AVE SUITE 46
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City | WAUSAU
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State | WI
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Zip | 54401-1705
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Country | US
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Telephone | 715-301-1123
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Fax |
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Provider Business Mailing Address
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Address Line | 605 S 24TH AVE SUITE 46
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City | WAUSAU
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State | WI
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Zip | 54401-1705
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Country | US
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Telephone | 715-301-1123
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Fax |
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DR. PETER ALLEN THROM
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Credential | D.C.
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Telephone | 715-301-1123
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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 | 4621-012
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License Number State | WI
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