Healthsource Of New Berlin | |
3333 S Sunnyslope Rd, 108, New Berlin, WI 53151-4502 | |
(262) 785-1811 | |
(262) 785-9887 |
Full Name | Healthsource Of New Berlin |
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Type | Facility |
Speciality | Chiropractor |
Location | 3333 S Sunnyslope Rd, New Berlin, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1871620310 | NPI | - | NPPES |
38921800 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | 3258 (Wisconsin) | Primary |
Provider Name | Michelle Stafford |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1477510949 PECOS PAC ID: 1557358595 Enrollment ID: I20130815000542 |
Mailing Address | Practice Location Address |
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Healthsource Of New Berlin Po Box 510444, New Berlin, WI 53151-0444 Ph: (262) 785-1811 | Healthsource Of New Berlin 3333 S Sunnyslope Rd, 108, New Berlin, WI 53151-4502 Ph: (262) 785-1811 |
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