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General NPI Number Information
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NPI Number | 1932322914
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Entity Type | Individual
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Provider Name | SCOTT PATRICK RISE D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 1370 PABST FARMS CIR SUITE 340
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City | OCONOMOWOC
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State | WI
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Zip | 53066-4879
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Country | US
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Telephone | 262-200-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 2795 CAMDEN LN
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City | BROOKFIELD
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State | WI
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Zip | 53045-3014
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Country | US
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Telephone | 262-786-6867
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3135
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License Number State | WI
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