Active Chiropractic & Rehabilitation Sc | |
502 Greene Ave, Green Bay, WI 54301-2820 | |
(920) 965-1155 | |
(920) 965-1156 |
Full Name | Active Chiropractic & Rehabilitation Sc |
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Type | Facility |
Speciality | Chiropractor - Rehabilitation |
Location | 502 Greene Ave, Green Bay, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790820314 | NPI | - | NPPES |
38949900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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111NR0400X | Chiropractor - Rehabilitation | (* (Not Available)) | Primary |
Provider Name | Matthew S Herber |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1467452789 PECOS PAC ID: 9234111485 Enrollment ID: I20040602001123 |
Provider Name | Matthew J Gallagher |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1144301078 PECOS PAC ID: 1759344302 Enrollment ID: I20041105000057 |
Mailing Address | Practice Location Address |
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Active Chiropractic & Rehabilitation Sc 502 Greene Ave, Green Bay, WI 54301-2820 Ph: (920) 965-1155 | Active Chiropractic & Rehabilitation Sc 502 Greene Ave, Green Bay, WI 54301-2820 Ph: (920) 965-1155 |
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