| Derrick Family Chiropractic Llc | |
|
6508 W Lincoln Ave, West Allis, WI 53219-2045 | |
| (262) 227-0700 | |
| Not Available |
| Full Name | Derrick Family Chiropractic Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 6508 W Lincoln Ave, West Allis, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285999524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4546-12 (Wisconsin) | Primary |
| Provider Name | Dana Marie Derrick |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730410838 PECOS PAC ID: 0042408353 Enrollment ID: I20101230000084 |
| Mailing Address | Practice Location Address |
|---|---|
| Derrick Family Chiropractic Llc 6508 W Lincoln Ave, West Allis, WI 53219-2045 Ph: (414) 328-1734 | Derrick Family Chiropractic Llc 6508 W Lincoln Ave, West Allis, WI 53219-2045 Ph: (262) 227-0700 |
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