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General NPI Number Information
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NPI Number | 1912024811
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Entity Type | Organization
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Legal Business Name | BETTER LIFE CHIROPRACTIC & WELLNESS SC
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 08/29/2014
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Provider Practice Location Address
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Address Line | 2217 S MEMORIAL PL
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City | SHEBOYGAN
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State | WI
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Zip | 53081-3715
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Country | US
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Telephone | 920-459-8477
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Fax | 920-459-8799
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Provider Business Mailing Address
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Address Line | 2217 S MEMORIAL PL
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City | SHEBOYGAN
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State | WI
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Zip | 53081-3715
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Country | US
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Telephone | 920-459-8477
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Fax | 920-459-8799
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Authorized Official
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Title or Position | OWNER
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Name | JOHN MICHAEL REITZ
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Credential | DC
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Telephone | 920-459-8477
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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 | 3945-012
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License Number State | WI
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