MEDICARE: WELLNESS WAY CHIROPRACTIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4716-012	WI

General Provider Information

NPI Number	:	1437494929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS WAY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	N83W13600 FOND DU LAC AVE
Second Line	:	UNIT #221
City	:	MENOMONEE FALLS
State	:	WI
Zip	:	53051-8104
Country	:	US
Telephone Number	:	262-384-0064
Fax Number	:

Provider Business Practice Location Address
First Line	:	10335 W OKLAHOMA AVE
Second Line	:	SUITE 202
City	:	MILWAUKEE
State	:	WI
Zip	:	53227-4100
Country	:	US
Telephone Number	:	262-384-0064
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LINSAY WAY
Credential	:	D.C.
Telephone Number	:	262-384-0064

Provider Enumeration Date	:	12/10/2012
Last Update Date	:	12/10/2012

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Directions to “WELLNESS WAY CHIROPRACTIC ” Practice Location

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