| Fontana Family Chiropractic | |
|
450 Mill St, Suite 102, Fontana, WI 53125-1242 | |
| (262) 275-5005 | |
| Not Available |
| Full Name | Fontana Family Chiropractic |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 450 Mill St, Fontana, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306045315 | NPI | - | NPPES |
| 000054027 | Other | MEDICARE | |
| 38966200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4188-012 (Wisconsin) | Primary |
| Provider Name | Jeremy L Bria |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1669531885 PECOS PAC ID: 3577570910 Enrollment ID: I20060313000038 |
| Provider Name | Ryan Jr Griffin |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548268816 PECOS PAC ID: 4183657869 Enrollment ID: I20180125001012 |
| Mailing Address | Practice Location Address |
|---|---|
| Fontana Family Chiropractic 450 Mill St, Suite 102, Fontana, WI 53125-1242 Ph: (262) 275-5005 | Fontana Family Chiropractic 450 Mill St, Suite 102, Fontana, WI 53125-1242 Ph: (262) 275-5005 |
Mr. Jeremy L Bria, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 450 Mill St, Suite 102, Fontana, WI 53125 Phone: 262-275-5005 Fax: 262-275-5004 | |
Wilson Chiropractic Llc Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 450 Mill St, Fontana, WI 53125 Phone: 262-373-9024 | |
Dr. Nicholas James Wilson, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 450 Mill St Ste 102, Fontana, WI 53125 Phone: 262-275-5005 |