Evergreen Chiropractic Sc | |
W69n968 Washington Ave, Cedarburg, WI 53012-3207 | |
(262) 375-4001 | |
Not Available |
Full Name | Evergreen Chiropractic Sc |
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Type | Facility |
Speciality | Chiropractor |
Location | W69n968 Washington Ave, Cedarburg, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1720867047 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Amanda Elyse Eberle |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1710252481 PECOS PAC ID: 0143506139 Enrollment ID: I20170405001086 |
Mailing Address | Practice Location Address |
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Evergreen Chiropractic Sc N67w5486 Columbia Rd, Cedarburg, WI 53012-2126 Ph: (815) 291-6681 | Evergreen Chiropractic Sc W69n968 Washington Ave, Cedarburg, WI 53012-3207 Ph: (262) 375-4001 |
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